Patient Accounts Representative organizes inpatient and outpatient claims for electronic or hard copy mail and forwards to appropriate third party payers. Reviews claims to make sure that payer specific billing requirements are met, follows-up on billing, determines and applies appropriate adjustments, answers inquiries, and updates accounts as necessary. Being a Patient Accounts Representative requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Patient Accounts Representative works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Patient Accounts Representative typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Job Requisition: REQ2096
Employment Type: Full-Time
Shift: Days (7am-3:30pm)
Hours Per Week: 40 hours
Location: Mental Health Childrens Clinic
Responsibilities:
• Reviews and processes insurance explanation of benefits statements for accuracy. Refers debit/credit balances to collectors and refers credit balances for resolution.
• Reviews accounts on which credit balances exist and determines reason for the credit balance.
• Appropriately adjusts the contractual allowance if in error, completes a transfer if a payment was applied to an incorrect account or requests a refund if an overpayment exists.
• Reports recurring insurance payment discrepancies and works with team to resolve. Identifies accounts on which contractual adjustments are incorrect by working the daily credit balance report.
• Reconciles bank deposits to payments entered into the financial system in a timely manner to ensure accurate account data.
• Reviews accounts and responds in a timely manner.
• Responds to third party inquiries and works to resolve circumstances that create unwarranted debit/credit balances
Education:
• High School Diploma/GED required
Complexity of Work:
• Within scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment.
Personal Protective Equipment:
• Follows Standard Precautions using personal protective equipment as required.
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