Patient Account Representative

Account ManagerSalesFull TimeRemoteSeniorTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

26 days ago

Salary

Not specified

Seniority

Senior

High School3 yrs expEnglish

Job Description

• Expedite and maximize payment of insurance medical claims by contacting third-party payors and patients including resubmission of claims, corrected claims, appeals, etc. • Complete post service denial tasks in accordance with established productivity and performance standards. • Collaborate with management in developing a plan to reduce aging of accounts with efficiency and maximum results. • Effectively communicate and collaborate with management to determine escalation of denied claims. • Identify claims processing issues upstream for denial prevention. • Demonstrate the expertise of all payors, including Medicare, Medicaid, and commercial payors. • Assist with knowledge sharing, payor, and department training, and provide support to other team members as advised by the manager and/or supervisor. • Identify, analyze, and escalate trends impacting AR collections. • Execute special projects to improve AR performance, as assigned.

Job Requirements

  • Three years physician billing experience, preferably in a large orthopedic physician practice.
  • Knowledge of EMR (Electronic Medical Record) (athenahealth preferred).
  • Ability to critically think through next steps on at risk accounts and resolve with optimal outcome.
  • Ability to prioritize workload for maximum benefit on aging accounts and to ensure that accounts do not age out beyond timely filing limits.
  • An ability to identify upstream blockers, prioritize solutions and communicate effectively.
  • Excellent communication and influencing skills; proven experience of influencing other teams/groups where their support is critical to success.
  • In-depth knowledge of CPT-4, ICD-10 and HCPCS coding, along with CCI edits.
  • Must have a comprehensive understanding of insurance pre-certification requirements, contract benefits, and medical terminology.
  • Managed care knowledge with the ability to differentiate between insurance plans such as Preferred Provider Organization (PPO), Point of Service (POS), Health Maintenance Organization (HMO), etc.
  • Ability to effectively communicate with physicians, clinic staff, patients, and co-workers consistent with a customer service focus and application of positive language principles.
  • In depth knowledge of third-party payer reimbursement policies and procedures.

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