Patient Financial Services

Accounts Representative

Location: 466 Lex 14th floor, Northwest, New York, NY

Local Schedule: Full Time, M-F 8AM-4PM

Contract: 13 weeks

Important Call Outs:

• NYP coversheet
• Positions are auto offer. Qualified applicants will be offered upon review. Client does have 24-48 hours to reject/decline an offers.

Required Qualifications

Education: High School diploma or GED

Experience: One year related experience

Two to four year's prior experience

PC/Data entry keyboarding skills

Effective communication skills

Solid working knowledge of third party insurance payors

Ability to demonstrate compassion and strong customer service skills

Bilingual (Spanish) Preferred

Key Responsibilities

The position of Account Representative may encompass different functions, all of which are similar in nature and the incumbent may perform one or more of those functions. The various functions include insurance verification, inpatient billing, outpatient billing, self-pay collections, insurance follow-up, remittance processing.

Responsible for obtaining and verifying insurance coverage by interviewing patients, families, and employers and by verifying coverage with insurance companies. Ensure that notifications, authorizations, pre-certifications are made, when appropriate. Assist self-pay patients in obtaining coverage for hospitalization, e.g., Medical applications, COBRA regulations. Secure promise of payments for patient for all non-covered services. Ensure that all patients are categorized correctly with regard to financial class, insurance company code, etc. Work with medical areas, e.g., Patient Case Management, physician's offices, to ensure that requested clinical information is supplied timely. Receive and process information required submitting a third party bill. Ensure that bills are complete and comprehensive, e.g. correct form for ID numbers, comprehensives of hospital charges, validity of CPT-4, ICD-9, and HCPCS codes. Ensure that billing amounts are correct with regard to case payers, managed care providers with contracts, DRG's day and cost outliners, implantable, exempt services, carve-outs, type of contract, services under NYPHRM, services under HCRA, etc. Obtain and submit all attachments, as required, such as biopsy reports, ambulance call reports, medical records, CMNs, Tao's. For electronic claims: maintain up-to-date knowledge with respect to electronic claim submission software and the various payers edits. Review and monitor all billing exception reports for correction/re-submission. Ensure that all claims are submitted in the accepted timeframe. Review and take appropriate action on account representative's respective portion of trial balance. If a self-pay patient, call patient for further insurance information and /or to secure payment or arrange payment plan. Resolve all credit balances by requesting refund to patient, insurance company, or make appropriate allowance transaction. Recommend further action, i.e. collection and/or legal after departmental collection policies have been exhausted. Respond to and investigate all patient inquiries involving financial issues; direct patients to appropriate parties to respond to clinical issues. Call insurance companies to secure payment. Take appropriate action upon denial or request for further information. Interface with Medical Records Department/physicians office/clinical area for requested information. Make claims corrections in accordance with compliance policies, payer regulations, and/or legal policies. Review exception reports received from remittance processing area and take appropriate action. Process all Medicare, Medicaid, and Client-payments for all participating hospitals through electronic remittance processing software. Post all checks and lockbox remittances manually. Prepare daily reconciliation of all remittances and checks posted to ensure that all payments and adjustments are done accurately and agree to deposits posted to general ledger. Review each payment for compliance to rules for carrier; post appropriate allowances. Refer all cases that have been paid incorrectly to the insurance follow-up unit. Make appropriate refund requests when overpayments have been identified. Ensure that payment posting is kept up-to-date. If assigned to Emergency Paramedics department, may assist in the research and preparation of statistical reports. If assigned to Emergency Paramedics department, may monitor entries of 911 call data by dispatchers. Reconcile all dispatch entries with documentation. Investigate, correct, and report discrepancies between data input and documentation. Review documentation for compliance with department policy and report any incidents of non-compliance. Performs other job related duties as assigned.

Axelon Services Corporation