Job Description

Summary:The Staff Pad is honored to partner with a non-profit healthcare system in Helena, Montana with superior care and a hometown commitment to be the gold standard for health care in Montana. We are in search of a Patient Account Representative to join their team.Responsibilities

• Performs pre-billing and billing functions to insure successful outcome of claim submission and payment.

• Follows all billing and regulatory guidelines, per insurance carrier, to insure facility compliance.

• Collaborates with all Team Members within SPH to insure an accurate and timely billing.

• Collect outstanding insurance company balances as quickly as possible by applying collection best practices as defined by Leadership

• Utilize various A/R reports to target aged balances for collection to meet and maintain performance goals.

• Evaluate partial payments to determine if further reimbursement is valid

• Compose technical denial arguments for reconsideration, including both written and telephonically

• Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument

• Escalate exhausted appeal efforts to Leadership

• Submits retro authorization to insurance within insurance carrier guidelines

• Researches and takes necessary action to follow up on unpaid claims using ATB\xe2\x80\x99s and/or assigned work lists

• Works pending claims in the CMS Direct Data Entry software (DDE) and SPH claims Clearinghouse

• Analyses insurance payments received to verify account was paid per contract, if not, contacts insurance to reprocess

• Use effective documentation standards that support a strong historical record of actions taken on the account

• Reviews and follows through on credit balances through take back initiation, refund initiation, and/or payment re-application.

• Reports Medicare credits quarterly to Medicare on appropriate form and supplies all supporting documentation

• Logs and adjusts all appropriate Medicare bad debt cancels so they can be reported on year-end financial reports.

• Works patient and insurance correspondence timely. Respond and document in account and scan documents into patient account for future reference.

• Response to all queries timely to insure Gold Standard Customer Service

• Role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit\xe2\x80\x99s performance expectations

QualificationsKNOWLEDGE/EXPERIENCE:

• Previous work experience in insurance billing regulations and understanding insurance contracts preferred but not mandatory

• Knowledge of state and federal regulations as they relate to the billing process preferred but not mandatory

• Proficient keyboard/ 10 key skills and working knowledge of computers required.

• Good verbal and written communication skills.

• Strong data entry, ten key skills and working knowledge of computer required.

• Exceptional customer service and interpersonal communication skills.

• Proficient in examining documents for accuracy and completeness.

• Ability to multitask and manage time effectively.

• Ability to grasp, retain, and apply new regulations

• Mathematical, organization skill and business correspondence skills.

• Basic knowledge in downloading/creating spreadsheets in Microsoft Excel

EDUCATION: High School diploma or GED required. Completes Patient Financial Services I training within first 5 monthPandoLogic. Category:Healthcare, Keywords:Medical Records Analyst, Location:Helena, MT-59604

The Staff Pad