Patient Account Representative

Company: The Staff Pad
Location: Helena
Posted on: November 16, 2024

Job Description:

Summary:
The Staff Pad is honored to partner with a non-profit healthcare system in Helena, Montana with superior care and a hometown commitment to be the gold standard for health care in Montana. We are in search of a Patient Account Representative to join their team.
Responsibilities

• Performs pre-billing and billing functions to insure successful outcome of claim submission and payment.
  
• Follows all billing and regulatory guidelines, per insurance carrier, to insure facility compliance.
  
• Collaborates with all Team Members within SPH to insure an accurate and timely billing. -
  
• Collect outstanding insurance company balances as quickly as possible by applying collection best practices as defined by Leadership
  
• Utilize various A/R reports to target aged balances for collection to meet and maintain performance goals.
  
• Evaluate partial payments to determine if further reimbursement is valid
  
• Compose technical denial arguments for reconsideration, including both written and telephonically
  
• Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument
  
• Escalate exhausted appeal efforts to Leadership
  
• Submits retro authorization to insurance within insurance carrier guidelines
  
• Researches and takes necessary action to follow up on unpaid claims using ATB's and/or assigned work lists
  
• Works pending claims in the CMS Direct Data Entry software (DDE) and SPH claims Clearinghouse
  
• Analyses insurance payments received to verify account was paid per contract, if not, contacts insurance to reprocess -
  
• Use effective documentation standards that support a strong historical record of actions taken on the account
  
• Reviews and follows through on credit balances through take back initiation, refund initiation, and/or payment re-application.
  
• Reports Medicare credits quarterly to Medicare on appropriate form and supplies all supporting documentation
  
• Logs and adjusts all appropriate Medicare bad debt cancels so they can be reported on year-end financial reports.
  
• Works patient and insurance correspondence timely. -Respond and document in account and scan documents into patient account for future reference.
  
• Response to all queries timely to insure Gold Standard Customer Service -
  
• -Role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance expectations
  Qualifications
  KNOWLEDGE/EXPERIENCE: -
  

• Previous work experience in insurance billing regulations and understanding insurance contracts preferred but not mandatory
  
• Knowledge of state and federal regulations as they relate to the billing process preferred but not mandatory -
  
• Proficient keyboard/ 10 key skills and working knowledge of computers required. -
  
• Good verbal and written communication skills. -
  
• Strong data entry, ten key skills and working knowledge of computer required. -
  
• Exceptional customer service and interpersonal communication skills.
  
• Proficient in examining documents for accuracy and completeness.
  
• Ability to multitask and manage time effectively.
  
• Ability to grasp, retain, and apply new regulations
  
• Mathematical, organization skill and business correspondence skills. -
  
• Basic knowledge in downloading/creating spreadsheets in Microsoft Excel
  EDUCATION: - - High School diploma or GED required. Completes Patient Financial Services I training within first 5 month
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  PandoLogic. Keywords: Medical Records Analyst, Location: Helena, MT - 59604 , PL: 594915805

Keywords: The Staff Pad, Great Falls , Patient Account Representative, Other , Helena, Montana