Patient Accounts Representative - Commercial Payers

Overview Scheduled Weekly Hours: 40. Perform third‑party billing functions within established third‑party regulations and requirements. Responsible for all aspects of hospital/professional claim review and resolution. Education & Experience High School Diploma or equivalent required. Minimum of 2 years of third‑party hospital/physician billing experience. Essential Job Functions Work assigned work queues daily/weekly to resolve claim denials in Cerner to ensure correct reimbursement and to avoid timely filing issues. Demonstrate computer literacy within the Cerner, SSI systems and third‑party websites. Examine incoming correspondence and review rejections to determine if follow‑up is necessary. Resolve claim denials or issues, identify if another department needs to be contacted for correct charge/coding information. Process third‑party refunds. Research and resolve misapplied monies posted to accounts incorrectly. Resolve problems with limited supervision, focusing on quality improvements. Monitor follow‑up reports and identify repeat claim errors by payer. Take appropriate action on delinquent accounts and report ongoing billing problems to the Patient Accounts Supervisor. Use all resources, including guidebooks and payer websites, to resolve claim issues before scoping them to management. Qualifications & Skills Excellent communication skills. Ability to multi‑task and work well in a team environment. Medicare billing experience is preferred. Attains and maintains knowledge of billing/accounts receivable data processing procedures and systems for routine data entry required for the billing process. Physical Demands Prolonged periods of sitting at a desk and performing computer work. Compensation Salary Range: $19.85 – $30.05 per hour. Compensation for new hires will be based on work history, experience, skill set, and education. This range does not include Sturdy Health’s benefits package, which includes healthcare, dental, vision, and retirement benefits for eligible employees. EEO Statement Sturdy Memorial Hospital is an equal employment opportunity employer. There is no discrimination because of race, color, creed, age, gender, sexual orientation, national origin, veteran status or disability. #J-18808-Ljbffr