Patient Accounting Representative II, PBO Follow Up, Full Time

Patient Accounting Representative II, PBO Follow Up, Full Time

Managing Revenue Cycle accounts receivable, following standard Operating Departmental Procedures to ensure prompt payment of payer and patient payments. Responsible for collaborating with other departments, or third parties, to drive payer and patient collections.

Responsibilities

Revenue Cycle Functions:

Communicates directly with payers to follow up on outstanding claims and achieve timely reimbursement. This may include obtaining claim status, submitting reconsiderations, or submitting appeals.

Monitors and reviews denial reason codes to identify root causes; works with payer contracting, other areas of the revenue cycle, and payer representatives, if necessary to resolve issues

Analyzes data to track collection efforts, identify trends, and provide team with updates and ideas for improvement

Monitors payer files for accuracy, ensures payer documentation is completed by follow-up staff, and assists in updating files with pertinent information as necessary

Assists other follow-up staff in identifying high-risk accounts and prioritizing follow-up efforts

Helps to work and resolve accounts from other staff members’ workloads to prevent backlogs and fills in as needed for absent staff

Maintains superior understanding of claims management, third-party payer guidelines, state and federal regulations, and all other functions of the job; educates and trains other follow-up staff as needed

Maintains compliance with HIPAA guidelines and ensures staff maintain discrepancy when handling patient information

Works independently to resolve claims issues

Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with supervisors and tracking progress

Offers suggestions to improve individual and team productivity

Maintains a quality review score of 90% or greater on department quality reviews

Assists supervisor with identifying departmental areas in need of improvements

Self-Development:

Attends 1 or more UC Health training and development courses per year

Other duties as assigned

Productivity:

Maintains 100% or greater each week on department productivity scoring and takes responsibility for individual productivity standards

Quality

Other duties as assigned

Qualifications

Education

Minimum Required: High School Diploma or GED. Preferred: Associate degree.

Experience

Minimum Required: 3 – 5 years of relevant experience in Revenue Cycle and/or Epic Revenue Cycle applications.

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