At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes – to every patient, every time. We are committed to caring for Long Island. Be a part of our team of healthcare heroes. Catholic Health is also proud to be voted one of Newsday's Top Places to Work on Long Island in 2018 and 2019 and Modern Healthcare's Best Place to work in both 2019 and 2020.
Under the direction of the Supervisor, the Patient Account Representative is responsible for accurate and timely hospital billing, follow up, collections, cash processing and customer service related activities.
- Reviews, corrects and approves all primary and secondary billing, submits hard copy or electronic claims to appropriate payors.
- Reviews and edits any rejections stemming from electronic billing submissions and corrects and resubmits claims, as required.
- Verifies accuracy of patient insurance and demographic information.
- Generates bills to patients for services not covered by insurance.
- Investigates duplicate payments and takes appropriate action to resolve. Initiates refund requests, where necessary, in accordance with departmental procedures.
- Perform follow up on all outstanding accounts assigned in accordance with established standards and procedures.
- Follows up on payer payment variances. Applies managed care contract rules to determine payment accuracy. Reports trends of payer behavior.
- Determines reason for denial and appeals accounts as necessary.
- Responds to all requests for information and telephone inquiries from patient, insurance carrier, physician office and outside agencies in a courteous manner.
- Cross trained in all phases of third party billing, follow-up, cash, credit and collections and customer service related activities.
- Establishes and demonstrates competency in accounts receivable systems and associated applications.
- High School diploma or equivalent required. Medical trade school preferred.
- One year of healthcare experience desired. Requires three to six months on-the-job training to become familiar with billing practices and policies.
- Ability to interpret third party coverage and institution's charges (rates) to patient.
- Ability to communicate effectively with others.
- Ability to comply with procedural guidelines and instructions and to solicit assistance when situations arise that deviate from the norm.
- Demonstrated competency operating a personal computer required.
- Excellent verbal and auditory skills are required for communicating with internal staff, customers and representatives from external departments and agencies.
At Catholic Health Services of Long Island your well-being comes first, with comprehensive compensation and benefits; our offerings go beyond the basics. In addition to multiple medical plans, life insurance, generous paid time off and flexible spending accounts, we also offer substantial tuition reimbursement, an employer funded pension plan and several savings plan options for your future.