Patient Account Rep Non Govt

ID 2021-8556
Location
Cone Health
Work Location
US-NC-Greensboro
Division : Name
Finance
Department : Name
SW-Non-Government Followup
Category
CLERICAL/ADMIN
Position Sub-Category
INSURANCE/BILLING
Position Type
Full Time
Employment Type
Employee
Exempt/NonExempt
Non-Exempt
FTE
1.00
Work Hours
40
Provider Schedule (specific schedule)
8:00 AM - 5:00 PM
On call Required
No
Sub Category
Insurance/Billing

Overview

 
This position is accountable for accurately analyzing and collecting balances on patient accounts, to include duties related to charges, filing, and follow up of third party insurance claims and correspondence in a timely and appropriate manner insuring that all policies, regulations and procedures are followed.  Talent Pool:Administrative & Clerical

 

Responsibilities

 

 
Acts as a liaison between Cones Health and multiple third party payers. Initiate contact with third parties to identify and subsequently resolve obstacles affecting payment. Review third party remittance advices to assure compliance with expected reimbursements and to initiate further action as needed to facilitate full reimbursement. Pursues unsettled insurance accounts in the method and manner prescribed by policy, (so that no more than 10-15 claims go beyond the 60 day standard per year without appropriate resolution or action taken.)

--------------------------------------------------

Analyze account balances to ensure accuracy of account for appropriate adjustments according to federal/state laws and hospital preferred provider contracts and in a timely manner; (with no more than 3-5 noted errors per year.)

--------------------------------------------------

Responds to requests to ensure reimbursement is obtained. Respond to third parties? requests for further information by coordinating with other Hospital departments such as Medical Records. Promptly responds to all telephone calls regarding patient accounts for review and analysis. Properly evaluates priorities and organizes time accordingly so that required activities are completed on a timely basis.

--------------------------------------------------

Maintain current working knowledge of changes in health care reimbursements. Attends seminars and weekly staff meetings. Follows all Corporate Compliance Rules and Regulations. Follows all HIPAA regulations without exception.

--------------------------------------------------

Ensures thorough, concise, and up-to-date documentation is maintained in accordance with procedure, so that collection efforts, responses to inquiries, and patient account status can be researched and verified, as necessary by all reps for customer service to utilize to assure accurate response in patient inquiry resolutions.

--------------------------------------------------

Maintain acceptable level of quality and production standards as determined by supervisory review and audit of assigned account categories. Notifies manager of possible or potential issues that may result in delays in payments or increase of denials.

--------------------------------------------------

Qualifications

 

EDUCATION:
High School Diploma or equivalent, Required

Associates, Preferrede

High School Diploma or its equivalency required; Associate Degree preferred.

 

EXPERIENCE:
3, Required

4-5, Preferred

Minimum of 3 years reimbursement experience in hospital, clinic or medical business office required; 4-5 years experience preferred.

 

LICENSURE/CERTIFICATION/REGISTRY/LISTING:
REQUIRED

N/A

PREFERRED

N/A

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed

Need help finding the right job?

We can recommend jobs specifically for you! Click here to get started.