IRA Services Representative jobs in Lancaster, PA

Schedule

Full-time: 40hrs/week

Hours: Monday - Friday, 7am - 3:30pm

Hybrid work model - Occasional days in the office is required

General Summary

Assists the Supervisor and/or Manager as required and provides assistance to coworkers to aid them in the completion of their daily tasks. Represents the System in a professional manner, using good customer service practices in the performance of the following duties: Is responsible for the electronic or manual billing and maintenance of patient accounts. Performs a variety of functions including, but not limited to, account follow-up, answering inquiries, resolving problems and interacting with third party payers and patients to achieve payment of accounts in accordance with current government and payer regulations.

Duties and Responsibilities

Essential Functions:

• Assists Supervisor with training new staff, as requested.
• Corrects financial and biographical information that has been in properly entered into the system.
• Performs various functions to complete and expedite the billing process including, but not limited to, completing deposit process including batching and scanning of EOB's and correspondence, recording patient identification data and physician diagnosis, investigating charges, correcting and updating data, preparing the claim to bill, posting payments, performing AR follow up on denials, and all other billing functions as assigned.
• Bills to third party payers via electronic or manual processes.
• Reviews accounts and coordinates with appropriate departments on accounts requiring precertification, preauthorization, referral forms and other requirements related to managed care.
• Reviews accounts and maintains contact with third parties to ensure timely payments. Makes written and/or verbal inquiries to third party payers to reconcile patient accounts. Follows up accounts until zero balance or turned over for collection.
• Reviews third party payer payments and investigates accounts not paid as expected. Takes appropriate corrective action to include follow up, rebilling, and/or adjustment of contractual allowances.
• Answers all inquiries regarding patient accounts.
• Interprets and explains to patients and their families' charges, services, and policy regarding payment of bills.
• Resolves billing problems and/or receives insurance updates.
• Processes and distributes copies of billings as required.
• Researches credit balance accounts. Refunds overpayments to patient, guarantor or third party payer.
• Receives and processes incoming payments, performs manual charge entry, and works Remittance WQ's. Reconciles daily cash and verifies account balances. Reconciles electronic payments and computer generated reports.
• Assumes responsibility to lead projects, as requested; may also lead process improvement initiatives.

Common Expectations:

• Types and/or compiles correspondence and reports, photocopies information, files information, answers the telephone, takes messages and directs calls.
• Prepares and maintains records of patient charges.
• Maintains department records, reports, files and census statistics as required.
• Maintains appropriate records, reports, and files as required.
• Maintains established policies and procedures, objectives, quality assessment, safety, environmental and infection control standards.
• Participates in educational programs and in-service meetings.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Required for All Jobs:

• Performs other related duties as identified.
• WellSpan Health has adopted and implemented a compliance program to support WellSpan's values and standards for professionalism, integrity, and ethics. Expected to support and meet the values and standards of the organization and the performance expectations of the job, the department, and the compliance program.
• WellSpan Health has adopted and implemented a privacy program to safeguard the patient information and the business and operational information of the organization. Expected to support and meet the values and standards of the organization to safeguard patient and business/operational information.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Physical Demands:

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Frequently
• Reaching - Rarely
• Talking - Frequently
• Hearing - Frequently
• Repetitive Motions - Occasionally
• Eye/Hand/Foot Coordination - Occasionally

Qualifications

Minimum Education:

• High School Diploma or GED Required

Work Experience:

• 2 years Relevant experience. Required

Licenses:

• Certified Revenue Cycle Specialist Upon Hire Required or
• Certified Professional Coder Upon Hire Required

Knowledge, Skills, and Abilities:

• Excellent communication and interpersonal skills.