Medicare/Medicaid - Patient Account Representative

Patient Account RepresentativeThe Patient Account Representative is responsible for collections, account follow up, billing allowance posting for the accounts assigned to them.Duties and ResponsibilitiesFollow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websitesReview and updates all patient and financial information accurately as givenVerify that information is accurate as to individual or insurance company responsible for payment of billMonitor all billings for accuracy, updating any errorsMonitor Medicaid/healthy options coupons to assure services are billed within expected timeframesBill all hospital services to primary insurer or patient correctly and within expected timeframeFollow up with insurance companies on all assigned accounts within expected timeframeExplain hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contractsIdentify and report underpayments and denial trendsAnalyze, identify and resolve issues causing payer payment delays; Initiate appeals when necessaryManipulate excel spreadsheets and communicate resultsMeet and maintain daily productivity and quality standards established in departmental policiesAct professionally, cooperatively and courteously with patients, insurance payors, co-workers, management and clientsMaintain confidentiality at all timesOther duties as assignedUse, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standardsUnderstand and comply with Information Security and HIPAA policies and procedures at all timesLimit viewing of PHI to the absolute minimum as necessary to perform assigned dutiesQualificationsHigh School Diploma or equivalent requiredMedical Billing and Coding certification preferred, but not requiredExperience in Hospital/Facility billing required2-3 years' experience in insurance collections, including submitting and following up on claimsBasic knowledge of healthcare claims processing including: ICD-9/10, CPT and HCPC codes, as well as UB-04Ability to use various workflow system and client host system such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accountsWorking knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologiesUnderstanding of government, Medicare and Medicaid claimsBasic math and typing skillsProficiency with Microsoft Office SuiteStrong interpersonal skills, ability to communicate well at all levels of the organizationStrong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analysesHigh level of integrity and dependability with a strong sense of urgency and results orientedExcellent written and verbal communication skills requiredWorking ConditionsMust possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.Work Environment: The noise level in the work environment is usually minimal.Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law. Med-Metrix