Patient Account Representative - Medical Billing/Revenue Integrity Office Job Opening

Patient Account Representative - Medical Billing/Revenue Integrity Office

Manchester Community Health Center

• Manchester, New Hampshire
$14.50 - $21.00 an hour
Category: Account Representative

We are seeking a positive, can-do individual who enjoys a dynamic and fast-paced environment to join our billing department.

The Patient Accounts Representative is responsible for various aspects of the revenue cycle process. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing and collections of accounts.

RESPONSIBILITIES & AUTHORITIES:

  • Ensures that all claims are reviewed daily and submitted electronically in a timely manner using the claims management system.
  • Reviews all claim edits/claim rejections and makes the necessary corrections ensuring compliance with all federal, state and specific commercial payer requirements.
  • Coordinates data requests with other departments in support of timely billing.
  • Prepares and submits manual paper claims as needed to third party payers’ who do not accept electronic claims or who require special handling.
  • Utilizes resources available to monitor outstanding claims for assigned payers’ (Work queues/Aging Reports) and ensures claim follow-up does not exceed payer filing limits.
  • Initiates re-billings, corrected claims and appeals following these specific payer requirements.
  • Documents billing activities on the patient account to assist in problem resolution within the billing system.
  • Uses knowledge of contracts and reimbursement to obtain the proper resolution.
  • Monitors assigned work to ensure billing and follow-up activities are maintained at the levels set by management.
  • Upon receipt reviews and determines the proper disposition of claims with credit balances.
  • Responsible for the daily reconciliation of charges, adjustments, and payments.
  • Post Medicare, Medicaid, Blue Cross/Blue Shield, and other third-party payments.
  • Post commercial checks and denials to individual client accounts. Pull copies of paid/unpaid claims from files. Resubmit bills and/or follow-up with insurance company when necessary.
  • Interact with clients in a positive and professional manner; sensitive in approach to discussions with clients regarding financial matters.
  • Other responsibilities as assigned by supervisor.

QUALIFICATIONS:


  • Education/Training: High School Graduate.
  • Experience: Two years experience with primary care, or related health care, insurance billing preferred.
  • Knowledge/Skills: Experience with computers and should demonstrate strong communication skills.