Patient Account Representative

Sheridan Memorial Hospital; Sheridan (WY); On-site; USD 42,000 - 52,000; Full time

Job summary

Sheridan Memorial Hospital is seeking a Patient Account Representative to join our billing team. You will compile itemized hospital bills, verify patient insurance coverage and compute benefits, working closely with Admitting, Medical Records and insurers.

This role participates in Performance Improvement activities to enhance billing accuracy and timeliness. This position requires a high school diploma (GED acceptable) and knowledge of medical terminology; billing or accounting experience is

Qualifications

• High school diploma or GED required; medical terminology preferred.
• Billing or accounting experience is preferred.
• Strong communication and organizational skills are essential.

Responsibilities

• Compiles itemized hospital bills and verifies insurance coverage.
• Computes patient insurance benefits and works with Admitting and Medical Records.
• Manages claim submissions and monitors reimbursement timelines.
• Communicates with patients and insurers to obtain required information.
• Maintains confidentiality and adheres to policies and standards.

Skills

Communication skills

Multiline telephone

Computer literacy

Confidentiality

Organizational skills

Education

High school diploma or GED

Medical terminology preferred

Billing or accounting preferred

Tools

Cerner RevenueCycle

Emdeon

Microsoft Excel

Job description

About this position

Patient Account Representative

About Sheridan Memorial Hospital

At Sheridan Memorial Hospital, we are proud to be ranking in the top 13.6% of hospitals rated by the Centers for Medicare and Medicaid Services. We believe that our ability to deliver excellent healthcare begins with our people, and we are proud of our more than 850 skilled, experienced, and caring employees. We have over 100 providers who specialize in 25 areas of expertise. Our facility is state-of-the-art, and we are dedicated to providing outstanding patient-centered care.

Nestled at the foothills of the Big Horn Mountains in northern Wyoming, spectacular scenery and outdoor activities abound. Our hospital has the latest technology and equipment comparable to that of many larger facilities, and you will find our staff is friendly, compassionate, caring, and courteous. We focus on creating and nurturing a workplace that encourages, recognizes, and rewards individual effort and creativity. Leadership is responsive to changing modes of healthcare delivery and adapts accordingly. We value effective communication and honesty and believe teamwork based on mutual respect is key to success.

Job Summary

Responsible for compiling itemized hospital bills, verifying patient insurance coverage and computing patient insurance benefits. Works closely with the Admitting Office, Medical Records and insurance companies. Participates in Performance Improvement activities.

Essential Duties/Responsibilities

• Verifies accurate encounter information by working Edit Failure Working in Cerner, making necessary corrections to insure timely claim submission.
• Monitors all claims in Emdeon correcting edits as need to insure claim submission and reimbursement.
• Contacts patients when additional information is required to file an insurance claim or when the insurance company has requested additional information from the member
• Stays informed about changes in Medicare and Medicaid, Blue Cross/Blue Shield and other third party payors.
• Processes correspondence and Explanation of Benefits in a timely manner.
• Processes overpayment refunds as required.
• Timely in making contact with insurance companies on claims that have exceeded the time expectation for payment.
• Remains current on Worker's Compensation and other third party payors for billing functions.
• Stays current on assigned patient encounter “workQ in Cerner RevenueCycle.
• Demonstrates the ability to be flexible, organized and function well in stressful situations.
• Interacts with patients/families in a professional manner. Provides explanations regarding statements, insurance coverage.
• Treats patients/families with respect; ensures confidentiality of patient records.
• Maintains a good working relationship within the department and with other departments.
• Maintains a professional working relationship with insurance companies.
• Performs other duties as assigned.
• Ensures documentation meets standards and policies.

Disclaimer: The above description has been designed to indicate the general nature of work performed within this position.

Position Qualifications — Education, Experience, Licenses and Certifications

• High school diploma or general equivalency diploma (GED), required.
• Medical terminology preferred.
• Billing or accounting preferred.

Additional Skills

• Ability to effectively communicate in English, both reading and writing.
• Multi-line telephone knowledge.
• Computer knowledge.
• Ability to operate designated equipment as specified including computer keyboarding.
• Basic clerical training, including basic filing procedures (both numerically and alphabetically).
• Ability to work under pressure with time constraints.
• Basic knowledge of medical record content and sequence.
• Ability to function independently with minimal direction.

Specific demands not listed: Possible exposure to blood and or body fluids / infectious disease / hazardous waste requiring the use of Personal Protective Equipment. Exposure to odorous chemicals / specimens and Latex products.
Pre-employment drug and alcohol screening is required.

Sheridan Memorial Hospital is an equal opportunity/Affirmative Action employer and gives consideration for employment to qualified applicants without regard to race, color, religion, age, sex, national origin, disability or protected veteran status.