Patient Account Representative - Long Term Care

Medical Billing Specialist

Bills for medical care provided to patients and/or residents by submitting claims electronically or by paper to either them or their designated third party payer. Maintains Accounts Receivables by follow-up with patients, residents, insurance companies, and other third party payers. Post collection notes, payments and adjustments by entering the appropriate codes and amounts in the Hospital's or Nursing Homes' Computer System.

Essential Functions

Bills for medical services by generating the appropriate bill jobs from Point Click Care (PCC).

Submit claims electronically via outside vendor billing software to Medicare, Blue Cross, MA and to commercial insurance companies by reviewing and editing claims for the appropriate third party payer billing information.

Maintains Accounts Receivables by posting the appropriate payments and adjustments.

Performs collection follow-up with patients, residents, insurance companies and other departments of Good Shepherd by telephone and/or letter.

Maintains appropriate files for patient accounts, charge slips, payment vouchers, payer referrals, and computer reports by ensuring that documents are completed and filed according to the Department's policies and procedures.

Request refunds by identifying overpayments and by completing check request form.

Provide face-to-face customer service on an as need basis, by answering patient or insurance representatives questions.

Contributes to Team Effort by accomplishing related results as needed.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education:

Associate's Degree or 3 years of equivalent experience required

Work Experience:

3-5 years of experience in healthcare billing required

Licenses / Certifications:

N/A