Biller - FT

General Summary

The Patient Account Representative will utilize the EMR and insurance systems to verify coverages and provide accurate information to allow for collection of all accounts. Maintain claims processing, including accurate and timely claim creation, follow-up and correspondence with insurance inquiries/correspondence. Assure payments are recorded and reconciled timely in order to maximize revenues. Counsels patients on financial matters to assure prompt payments are received for services.

Minimum Qualifications

• Must demonstrate a working knowledge of CPT and ICD-10 coding systems. Knowledge of individual codes not required.
• Must demonstrate experience with verifying insurance eligibility, including with Alabama Medicaid’s State Eligibility System.
• Must demonstrate sound knowledge of medical collection practices.
• Must show the ability to learn and understand an electronic medical record.
• Must show the ability to have excellent interpersonal skills and communication to interact with all walks of life, internal and external to UCA, from all educational or cultural backgrounds.
• Must show the ability to work independently or within a team in a fast-paced environment.
• Must show proficiency in use of a variety of office equipment including a PC, Windows, MSOffice, EMR system, multi-line telephone, copier, facsimile machine, etc.
• Must show the ability to maintain confidentiality, including strict adherence to HIPAA and UCA Guidelines.
• Must have a high school diploma or GED equivalent.

Preferred Qualifications

• May have an associate degree or higher in medical billing and coding.
• May have three (3) to five (5) years’ experience in healthcare billing claims.
• Show experience with Greenway or Allscripts EMR system.

Licensure, Certification, Registration Requirements

None.

Supervisory Requirements

This position will not supervise any other staff members.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; stoop, kneel, crouch, or crawl; and talk or hear. The employee must occasionally lift and/or move more than 25 pounds.

Essential Functions

• Prepares and submits clean claims to third party payers either electronically or by paper.
• Maintains relationship with clearinghouse, including appropriate follow-up with support issues.
• Coordinate the process of patient eligibility through various third-party sources.
• Coordinate collection process, to include any projects from Greenway accounts and tracking in soon to be collections in Allscripts.
• Maintain monthly statement process.
• Escalate patient issues to Director of Revenue Cycle.
• Work with reception staff, ensure appropriate collection of co-pays, deductible and self-pay fees.
• Handles patient inquiries and answers questions from clerical staff and insurance companies.
• Identifies and resolves patient billing problems.
• Denial and insurance follow-up management.
• Issues adjusted, corrected, and/or rebilled claims to third party payers.
• Posts adjustments transfer of responsibility and refunds, as necessary.
• Assure coding is compliant and up to date.
• Reviews accounts and makes recommendations to the Director regarding non collectible accounts.
• Other relevant duties as assigned.