The Billing Account Representative reports directly to the Medical Service Revenue Manager. Under general supervision, may participate in any or all aspects of the patient processing and accounts receivable functions of the organization including billing, charge entry, collection, registration, scheduling, follow-up, coding, payment posting and credit balance resolution. May balance monthly transactions and provide summaries to department administration. They will have detailed knowledge of the Functions within the Revenue Cycle and how they interact in the life of a patient account.
DUTIES AND RESPONSIBILITIES
· Identifies problem accounts with payors; investigates and correct errors follow-up on missing account information, and resolves past-due accounts.
· Performs various collection actions including contacting patient by phone, correcting and resubmitting claim to third party payers.
· Prepares reviews and send patient statements.
· Answer inquires by phone regarding past-due accounts and insurance guidelines.
· Handle inbound patient, insurance company and internal calls regarding billing inquiries, customer complaints and eligibility.
· Process credit card payments.
· Independently maintain uninsured work queue for assigned accounts.
· Accurately post insurance remittance and patient payments.
· Follow internal policies and procedures for payment posting guidelines relating to payer fee schedule..
· Transfers bills to secondary or tertiary accounts, if applicable.
· Post adjustment and write offs to appropriate accounts.
· Prepare reports to identify and resolve accounts receivable.
· Monitor aging reports and take such steps as necessary to guarantee payments of claims.
· Make adjustment to either patient or practice accounts based on internal reports and/or documentation.
· Ability to read and understand different Explanation of Benefits.
· Must keep supervisor informed of areas of concern and problems identified.
· Contact agency representative to verify type and extent insurance coverage.
· Accepts assignments from management and maintain open communication with their manager to resolve quality and production issues.
· Assist with yearly financial audit.
· Maintains strict confidentiality regarding confidential conversations, documents and files.
· Participates in educational activities and attends monthly staff meetings.
· Adheres to all HIPAA guidelines/regulations.
· Performs other duties as assigned.
- High School diploma or GED required/Associates' degree preferred
- Understanding of payer EOBs/Remits
- Strong computer skills including Microsoft Word, Excel, and fast and accurate typing skills
- Minimum of 2-4 years' experience using ICD-9-CM, Volumes 1- 3, CPT, HCPCS, and IHS coding conventions.
KNOWLEDGE & EXPERIENCE REQUIRED BY THE POSITION
· Must demonstrate ability to work independently with minimum supervision in a team-oriented environment and interrelate well with individuals with diverse ethnic and cultural backgrounds and needs
· Advance knowledge of medical codes involving selections of most accurate and description code using the
· Excellent oral, written and telephone communication