Full-Time Patient Account Representative

Harboroaks; Riverdale (GA); On-site; USD 42,000 - 54,000; Full time

Job summary

Harboroaks is seeking a focused hospital billing specialist to manage patient accounts and collections in a fast paced environment in Georgia. You will call third party payors, review and correct claims, rebill when needed, and ensure accurate explanations of benefits.

Daily duties include using a patient accounting system to track 30-40 accounts, prorating balances, and preparing adjustments with supporting documentation.

Qualifications

• High school diploma or equivalent required.
• Three or more years’ prior admissions and/or collections experience in a hospital setting required.
• Psychiatric experience preferred.

Responsibilities

• Call and status outstanding claims with third party payors.
• Review claims issues and make corrections as needed and rebill.
• Utilize claims clearing house to review and correct claims. Resubmit electronically when available.
• Review explanation of benefits to ascertain that claim processed and paid correctly.
• Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.
• Manage daily productivity via patient accounting system and productivity reports. Needs to maintain an average of 30-40 accounts worked per day minimum.
• Prorate patient accounts and monitor that balance due is in the correct financial class.
• Report an overview of the week to the BOD and participate in AR meetings.
• Gather and interpret data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.
• Assist financial counselors as needed.
• Alert Financial Counselors and Business Office Director of all benefit eligibility matters that suggest or challenge reimbursement.

Skills

Third party payor claims handling

Claims review and correction

Claims clearing house usage

Benefit analysis

Data interpretation and reporting

Coordination with financial counselors

Education

High school diploma or equivalent

Hospital admissions/collections experience

Tools

Patient accounting system

Claims clearing house software

Job description

Responsibilities

• Call and status outstanding claims with third party payors.
• Review claims issues and make corrections as needed and rebill.
• Utilize claims clearing house to review and correct claims. Resubmit electronically when available.
• Review explanation of benefits to ascertain that claim processed and paid correctly.
• Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.
• Manage daily productivity via patient accounting system and productivity reports. Needs to maintain an average of 30-40 accounts worked per day minimum.
• Prorate patient accounts and monitor that balance due is in the correct financial class.
• Report an overview of the week to the BOD and participate in AR meetings.
• Gather and interpret data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.
• Assist financial counselors as needed.
• Alert Financial Counselors and Business Office Director of all benefit eligibility matters that suggest or challenge reimbursement.

Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• High school diploma or equivalent required.
• Three or more years’ prior admissions and or collections experience in a hospital setting required.
• Psychiatric experience preferred.

LICENSES/DESIGNATIONS/CERTIFICATIONS:

• Not applicable

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