Insurance Claims Representative -- PATIENT FINANCIAL SERVICES -- Preston Memorial Hospital

Job Summary

With a patient centered culture, the Insurance Claims Specialist provides a positive experience for our patients and customers by managing the patient accounts during pre and post claims processing. This management includes accurate claim submission with payee guidelines, timely accounts, follow- up and assistance with denial management issues to ensure the financial viability of Mon Health.

Responsibilities

Account Management: Maintains knowledge of revenue cycles operations, third-party reimbursement by local/state/federal payers.

Customer Service: Ensures that patients, family members and customers are given exceptional service during their patient registration process. Takes actions to resolve patient conflicts in a manner that is best for the organization and the individual(s) involved. Speaks in a clear and concise manner, selects the right tone and displays appropriate body language for the situation and audience while demonstrating active listening skills. Demonstrates an awareness of, and sensitivity to, the needs and concerns of individuals from different cultures.

Quality/Accuracy: Applies all codes according to established coding guidelines with an accuracy rate as determined and established by department policy or guidelines.

T ime Management: Meets productivity standards that have been established for the position and/or department. Prioritizes multiple tasks. Completes assignments per protocol or as directed. Embraces new and innovative approaches that will improve efficiency.

Understanding Roles and Responsibilities: Takes responsibility for clarifying job responsibilities, including the need to understand performance standards and other expectations. Communicates with supervisor regularly to ensure that there is no misunderstanding about how performance will be measured and how expectations relate to the job. Seeks clarification as needed or when responsibilities are not understood. Willingly accepts change.

Knowledge, Skills & Abilities

Light Work: Exerting up to 20 lbs. of force occasionally and/or up to 10 lbs. frequently and/or negligible amounts constantly.

One (1) year experience in healthcare billing/revenue cycle patient accounting OR a graduate of a medical billing/coding or medical office program required. Knowledge of patient billing practices, medical terminology, patient registration, and federal, state and third-party billing regulations preferred.

Education

• High School Diploma or GED (Required)

Credentials

• Basic Life Support (Required)

Work Schedule: Days

Status: Full Time Regular 1.0

Location: Preston Memorial Hospital

Location of Job: WV:Kingwood:Preston Memorial Hospital

Talent Acquisition Specialist: Guy S. Stewart guy.stewart@vandaliahealth.org