Senior Patient Account Representative - Revenue Integrity

General Description: 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 reconcile daily IDX system receivables reports. May balance monthly transactions and provide summaries to faculty and department administration.

Essential Responsibilities:

• Patient scheduling
• Patient registration
  • Review patient admitting records and extracts relevant information
  • Records patient identification and demographic information in the computerized billing system
  • Contacts agency representatives to verify type and extent of coverage.
• Charge entry
  • Performs preliminary review of source documents to determine that sufficient data are present for processing
  • Using alphanumeric keyboard, transcribes and/or verifies data from source documents to the medium used for entering data into the computer
  • Batch charges
  • Generate cash totals
  • Enter charges
  • Balances batches by comparing batch proofs to source documents and hash totals
• Billing
  • Works with all areas of the organization in getting any necessary or requested documentation for patients, insurance carriers or other areas.
  • May interact with hospital patient accounting or records personnel to obtain patient demographic or other billing information
  • Operates hospital information system terminal to obtain patient demographic information, patient insurance information and status of approvals or denials
  • Completes processing of all inpatient and outpatient documents received on a daily basis
  • Assists in resolving department problems with IDX billing
  • Maintains records of charges, payments, third party charges, etc.
• Collection
  • Answers patient's questions regarding statements, agency coverage, etc.
  • Handles correspondence regarding collection activity and records results
  • Identify patient accounts for collection action when accounts become delinquent or when unable to contact patient or responsible party
  • May receive patient payments and/or issue payment receipts
• Coding
  • Record CPT codes on billing form
  • Record ICD-9 codes on billing form
• Follow-up
  • Initiates contact with patients and/or third party carriers if there is a delay in responding to statements or claims
  • May process incoming and outgoing mail
  • May receive incoming telephone calls and resolve issues communicated
  • Records results of mail and telephone contacts on the computer billing system
  • Contacts insurance carriers regarding non-payment and/or improper payment of claims
  • Reviews denials
  • Interfaces with patients, physicians, and others regarding professional billing operations and funds
• Payment posting
  • Post receipts to proper patient accounts
  • Posts denials
  • Compare batch proofs and source documents for accuracy
• Reporting
  • Assists in reviewing and balancing IDX transaction reports for administration
  • Reconciles daily IDX receivables reports
  • Prepares billing statements from statistical data
• Credit balance resolution
  • Review daily billing and accounts receivable credit balance reports
  • Prepare daily refund check requests
  • Prepare other daily credit balances other than refunds
  • Post refund checks to patient accounts
  • Mail refund checks with supporting documentation

General Responsibilities:

• Performs other duties as assigned.

Minimum Requirements:

Education: None required.

Experience: 1.5 years of experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other billing system) required.

Licensure/Certifications/Registrations Required:None required.

Knowledge, Skills, and Abilities:

• Attention to detail
• Excellent verbal and written communication skills
• Proficient with the use of Microsoft Office tools