Patient Accounts Representative Specialist

Patient Accounts Representative Specialist

Directly responsible for daily billing of insurance claims and collection activity on outstanding payor accounts and self-pay encounters to manage account receivables. This position is accountable for monitoring and reconciling accounts with appropriate workflow processes to ensure accurate account resolution. Has thorough knowledge of third-party carriers; government payors; special programs; and University Health Financial Assistance program. Meets quality measures set forth by regulatory compliance standards, Federal Regulations, and department protocols.

This position is considered a subject matter expert and serves as a role model for current staff members. Uses a variety of electronic systems in the course of this work and displays high customer service standards. Responsibilities may include generating regular reports to assist the Manager and/or Director of the department. Identify process development or improvement for current on-going activities. Assist in team meetings by supplying input on trends, issues, or payor notices. This position uses high level of proficiency and knowledge to ensure quality and efficiencies in operational processes. Requires independent and critical thinking skills.

Minimum Requirements:

• Associates degree or equivalent in combination of education and experience.
• Three (3) years' minimum experience with insurance billing and/or claims follow up in a hospital business office, physician's office, or insurance billing environment or relevant experience in use of billing and claims knowledge. Or a total of seven experience in lieu of an associate's degree
• Experience in commercial insurance, Medicare, and Medicaid reimbursement Must have computer literacy and math aptitude, and the ability to use 10-key calculator, computer key board and basic software applications, including Excel, Word and Outlook
• Must have demonstrated the ability to lead lower classified Patient Account Representatives
• Requires extensive knowledge of third party billing procedures acts as a day-to-day subject matter expert in their particular area of expertise.
• Experience with 837i and HIPAA transaction sets such as ICD/CPT/HCPC coding, revenue codes, ICD-10 and knowledge of medical terminology
• Good oral and written communication skills