Patient Accounts Representative jobs in Indianapolis, IN

Central Indiana Orthopedics is looking for outstanding individuals interested in being part of a team environment. Successful candidates will be hardworking, willing to learn and grow, and anxious to be part of a culture focused on outstanding patient care. Individuals must be dependable and demonstrate a positive work ethic.

The Patient Accounts Specialist (Fishers ASC) is responsible for all aspects of patient accounts for the Surgery Center. This position will work with both insurance companies and individual patients to ensure accounts are current and receiving the maximum amount of reimbursement and payment for services performed in the Surgery Center. Individuals in this position are responsible for analyzing delinquent accounts, researching denials and claim delays with insurance companies, and receiving and evaluating reimbursements from insurance companies to verify they are accurate. This position will ensure timely collection of payments from self-pay patients; work with patients to cure open account issues; be responsible for regular reporting; researching reimbursement opportunities; and work closely with the Director of Surgery. Additionally, this position is responsible for all billing of surgical procedures performed at the Fishers ASC, ensuring accuracy with the goal of billing clean claims leading to timely collections. This position will interface with doctors and clinical staff regarding information on costs and charges for surgical procedures.

Roles and Responsibilities

Insurance Follow-Up

• Interface with insurance providers to ensure all discounts or special rates are applied to the bill and information is accurate to ensure timely payment by the insurance company.
• Research denials or delays in payment, processing appeals and filing additional information as necessary, with a goal of obtaining maximum reimbursement.
• Explain surgical billing and payment procedures to patients, responding to patient requests regarding their accounts and assist them with claim issues.
• File insurance claim forms and explanation of benefits statements for outstanding accounts.
• Assist with coding and error resolution to ensure patient accounts are accurate.
• Maintain accurate and complete notes in the NextGen system regarding account status and actions taken on each account.

Self-Pay Accounts

• Evaluate and process work log of accounts daily, working accounts completely and accurately, following through to obtain maximum payment.
• Respond quickly to all patient account phone line calls and to patient arrival calls.
• Complete all required documentation to provide a solid, accurate and up-to-date patient record, ensuring timely communication/information for the Patient Accounts team.
• Collect outstanding balances for the Practice and CIO Surgery Center.
• Communicate and explain the Care Credit program to patients as needed, process applications and run payments for Care Credit.
• Maintain accurate and complete notes in the NextGen system regarding account status and actions taken on each account.

Posting and Billing

• Bill in an accurate and timely manner, in accordance with operational policies, all elective surgical procedures for all procedures performed in the Fishers ASC.
• For elective cases, update NextGen with the patient arrival data, update the correct insurance encounter, add the date of first symptom or injury, and place any holds on the account if necessary.
• Review and post charges, ensuring accuracy with a goal of billing clean claims.
• Maintain familiarity with CIO Fishers ASC contracts and bill all facility fees for procedures performed in CIO Fishers ASC.
• Assist with cost estimates by researching and documentation allowed amounts or charges for procedures.

Reporting & Research

• Review insurance contracts, with input of Director of Surgery Center, to ensure contracts are up-to-date, accurate, and obtaining the best reimbursement possible for the center.
• Interface with insurance companies and other resources to determine areas of improvement for reimbursement rates for the Surgery Center.
• Run reports, evaluate, and produce data and reports on a regular basis to assist the Director of Surgery and Board in making operational and financial decisions for the Surgery Center.

Education, Experience and Certification/License Requirements

Minimum high school diploma or GED required. An Associate’s or Bachelor’s degree in health care management or health care administration preferred. Minimum of 2 to 4 years previous experience in patient accounts or health care collections field required. A combination of experience and education may be substituted for experience requirement. Previous experience in a clinical or surgical environment required. Previous customer service experience, electronic medical records experience, and financial experience in a medical office are required.