Full Time Patient Account Representative III

Jimmy Jazz; Reedsport (OR); On-site; USD 42,000 - 58,000; Full time

Benefits offered by this job

Benefits

Job summary

Lower Umpqua Hospital District in Reedsport, OR is seeking a Patient Account Representative III to manage patient accounts from initial billing through collections. You will work closely with insurance carriers, review eligibility, submit claims, and handle denials with accuracy and attention to confidentiality.

The role requires experience with Meditech and Ability systems, strong data accuracy, and effective communication.

Qualifications

• High School graduate or equivalent preferred.
• Experience with billing and/or collections is preferred.
• Proficiency with computers and Microsoft Office Suite is required.

Responsibilities

• Process patient accounts from initial billing to collection.
• Verify insurance eligibility and claim status using Meditech and Ability.
• Submit 1500 and/or UBO4 claim forms to insurance carriers timely.
• Follow up on reimbursement for outstanding claims and file appeals.
• Prepare clear denial letters and manage ATB reports as directed.

Skills

Typing

10-key by touch

Attention to detail

Verbal and written communication

Confidentiality

Teamwork

Billing regulations

Education

High School diploma or equivalent

Tools

Meditech

Ability

Microsoft Office

Job description

• Location 600 RANCH RD,Reedsport, OR, 97467-1795,United States
• Employee Type Non-Exempt

LOWER UMPQUA HOSPITAL JOB DESCRIPTION

Business Office

POSITION TITLE: Patient Account Representative III

Reports to: Business Office Manager

Classification: UFCW

Supervisory: none

Last Revised/Reviewed/ Approved by HR: 11/30/2022

JOB SUMMARY

The Patient Account Representative III is responsible for processing all assigned patient accounts from initial billing to collection of all amounts due from each of the patient’s insurance carriers. Be in accordance with established departmental and Health Systems policies, procedures, and standards.

ESSENTIAL DUTIES

• Ensures accuracy of data, complete account checks, task, denial and credit balance work list in Meditech.
• Ensures accuracy of data, complete claim checks, hold, rejections and RTP in Ability, release claims to correct payor for appropriate processing.
• Manually or electronically submits 1500 and/or UBO4 claim forms in a timely manner to insurance carriers for processing
• Working knowledge of insurance portals to ensure account accurate eligibility, verify claims processing, work claim appeals and locate explanation of benefit (EOB) when necessary.
• Conducts follow up for reimbursement on outstanding claims.
• Conducts appeals and reconsiderations to insurance companies for reprocessing insurance claims.
• Investigates, problem solves and identifies trends that are keeping claims from processing. Notifies Manager and/or Lead of related issues.
• Responsible for creating clear and concise denial letters.
• Responsible for working Age Trial Balance (ATB) reports as directed by Lead and/or Manager.
• Responsible phone inquiries from patients, insurance carriers, and physicians regarding accounts.
• Works independently or in a collaborative work environment.
• Verifies insurance reimbursement to ensure correct contract amounts are received. Calculate and perform appropriate adjustment request for processing.
• Review credit balance accounts taking appropriate action, e.g., prepares an adjustment request, or processes account for refund.
• Document in detail each account worked on status and resolution expectation.
• Generates letters to patients when insurance is requesting additional information from the insured.
• Works collaboratively with Leaders, Team Members and other departments establishing best practice procedures throughout Lower Umpqua Hospital District to ensure cash receivables and patient satisfaction is met.
• Maintains confidentiality of employee, patient, and Health System information.
• Attends meetings and all mandatory in-services as required or requested.
• Maintains Health System core values of quality, caring, ownership, pride, teamwork, respect, and responsibility.
• Participates in performance improvement activities of the department.
• Performs other duties as assigned by the Business Office Manager.

QUALIFICATION REQUIREMENTS

Education and License:

• High School graduate or equivalent, preferred.

Experience

• Previous clerical work experience, preferred.
• Minimum of 2 years of billing and/or collections work, highly desirable.
• Experience working with computers and Microsoft Office Suite, required.
• Any combination of education and experience, which would provide the necessary knowledge, skills and abilities to meet the minimum qualifications to perform the essential functions of this position.

Additional Qualifications

• Basic typing skills with accuracy and 10-key by touch
• Must be detailed oriented and accurate in working with figures.
• Able to clearly and effectively communicate both verbally and writing.
• Requires flexibility, tact, and sensitivity in dealing with the public and other personnel, and able to maintain confidentiality of patient records.
• Must be able to work as an effective member of the healthcare team, and to establish and maintain cooperative working relationships with others, utilizing tact and diplomacy.
• Requires verbal communication with insurance carriers, patients, physicians, co-workers, and personnel from other departments in person and over the phone.
• Requires reading billing requirements and regulations, medical reports, and other written materials.

WORK ENVIRONMENT

Works indoors in an air-conditioned environment.

PHYSICAL DEMANDS

Frequent use of computer and phone, and other standard office machines. Must be able to stand, sit, stoop, twist, kneel, reach, push, pull using proper body mechanics and move/lift varying amounts of weight to a maximum of 20 lbs.

This is a full-time position and eligible for benefits.