Patient Account Representative

Job Summary:

You will be required to have extensive knowledge to review, analyze, and interpret regulations and standards for appropriate coding billing to insure third party payor regulations and standards to maximize reimbursement for services rendered.

Job Duties/Responsibilities:

Knowledge of third party payer procedures and coding guidelines

Responsible for review, analysis, and interpretation of regulation for proper coding

Submit claims electronically to payors

Submit appeals to insurance companies for incorrect processing of claims

Communicate with case management for peer to peer review on outstanding denials

Follow all regulatory guideless from CMS on LCD and NCCI edits

Assign appropriate modifiers to all outgoing claims

Contact third party payor on outstanding claims that are unresolved

Handle patient complaints either internally or by contacting other departments to resolve their issues.

Understanding explanation of benefits

Posting of payments and denials to patient accounts

Performs other duties as assigned

Education Experience:

HS Graduate or Equivalent

Years of Related Experience:

1-2 Years

License/Certificate Required:

No

Driver's License Required:

No

Travel Requirements:

None

Age Requirement:

18+

Job Requirements:

Familiarity with or the ability to quickly learn Electronic Medical Record system (CPSI)

Exceptional customer service skills

Excellent verbal and written communication skills

Ability to act with integrity, professionalism, and confidentiality

Strong time management skills with a proven ability to meet deadlines

Accurate data entry

Ability to multi-task

Abide by all hospital and HIPAA policies

Preferred Skills:

Knowledge of ICD10, CPT, and HCPCS coding guidelines

Knowledge of medical terminology