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Patient account rep - claims

Company Name:
Elliot Hospital
PATIENT ACCOUNT REP - CLAIMS
Department: PATIENT ACCOUNTS
Schedule: 7:30A-4:00P
Shift: Monday - Friday
Hours: 40
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Position Summary:
The Patient Accounts Representative is responsible for various aspects of the revenue cycle process. This position primarily supports the Central Billing Office for Elliot Health System. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing and collections of accounts.
Key Responsibilities:
Ensures that all appropriate claims are submitted electronically.
Ensures that all claims are reviewed daily and are transmitted in a timely manner using the claim management system.
Reviews all claim edits and does corrections with a thorough understanding of federal and state regulations as well as specific commercial payer requirements in order to promote compliant claim submission practices.
Responsible to work EPIC DNB s and EPIC Workqueue s as assigned
Coordinates medical record requests as needed.
Documents billing activity on the patient account as necessary.
Processes any claim rejections in the claim management system.
Monitors claim rejections for trends and issues and reports findings to supervisor.
Prepares and submits manual insurance claims to third party payers who do not accept electronic claims or who require special handling.
Participates in staff training that align with recognized improvement opportunities to increase understanding of specific payer requirements as well as general billing practices.
Required Knowledge, Skills and Abilities:
Maintains an in depth knowledge of the software system in areas related to billing and registration.
Maintains knowledge of CMS guidelines and third party payers, Medicaid, Managed Care products, Workers Compensation, motor vehicle accident, and liability plans.
Demonstrates strong organizational skills, attention to detail, with timely follow through.
Strong written and oral communication skills.
Ability to work in a fast paced, multi-task, environment
Good judgment and problem solving skills.
Ability to work independently and take initiative
Ability to communicate and interrelate professionally with all patients, visitors, Providers, and staff focusing on strong and proactive customer service.
Ability to accept constructive feedback and initiate appropriate actions to correct situations.
Knowledge of Confidentiality Policies and Procedures and Policies and Procedures of Elliot Health System.
Ability to convey detailed or important information to employees, patients, internal staff and third party payers.
Education:
High school diploma or equivalent required.
Experience:
Two (2) years ofmedical billing, collections or related experience preferred.
Software/Hardware:
Computer, telephone, fax machine. EPIC Billing experience preferred.
ElliotHealth System is an Equal Opportunity Employer and an Affirmative Action Employer.
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