Description
SCHEDULE: TEMPORARY On-call; Less than 16 hours per week; Flexible workdays Monday - Friday
The Patient Accounts Representative is responsible for all insurance claims processing, from submission to payment according to contract. He/she is involved in the billing process and is required to perform all general office functions as well. He/she must reflect a positive, well-mannered attitude in all contacts. The Patient Accounts Representative adheres to the philosophy and mission of Myrtue Medical Center in all aspects of job performance.
Requirements
High school diploma required. Medical insurance training would be an asset, but not necessary. Certain certifications may be required. Accounting, general office, keyboarding and medical insurance experience preferred.
Summary
Keeps abreast of all reimbursement changes in insurance, Medicare, Title XIX, MCO and PPO rules and regulations. Investigates denied claims with Myrtue billers. Researches unpaid/under paid claims according to department standards. Provides timely feedback to management of identified claims issues, repetitive errors, and payer trends to expedite claims adjudication. Distributes payments to accounts on date received and reviews account balances for further action. Makes necessary payment notes in patient accounts. Handles reimbursement questions from Myrtue billers, accounting and Patient Financial Advocates. Works directly with payers and internal/external customers toward effective claims resolution. Makes necessary telephone calls to payers in accordance with policy. Reviews credit balances and takes appropriate action to correct account. Requires a strong aptitude for detail. Note: This is a partial listing of key job areas. For a complete job description, please contact HR.