Patient Account Representative I - Hospital Biller (Remote)

ScionHealth; Brentwood (TN); Remote; USD 35,000 - 55,000; Full time

Job summary

An established industry player in healthcare is seeking a Patient Account Representative I to join their remote team. This role focuses on medical billing and Medicare claims, ensuring accurate submissions and timely follow-ups. Candidates will engage in various tasks, including processing claims, managing accounts receivable, and collaborating with internal teams. The ideal candidate will possess strong communication skills and a solid understanding of medical billing practices. This is a fantastic opportunity to contribute to a vital sector while enjoying the flexibility of remote work.

Qualifications

• At least 2 years of hospital or physician office billing experience preferred.
• Experience with billing systems to ensure efficient claims processing.

Responsibilities

• Correct, complete, and process claims for all payer codes.
• Analyze and interpret claims to ensure accuracy before sending to insurance companies.
• Manage A/R collection opportunities on unpaid claims.

Skills

Effective verbal and written communication

Ability to work independently

Basic accounting and bookkeeping skills

Strong customer service skills

Knowledge of medical billing and terminology

Education

High School Diploma or GED

Tools

Epic

SSI

Microsoft Excel

Microsoft Word

Job description

Join to apply for the Patient Account Representative I - Hospital Biller (Remote) role at ScionHealth.

This is a remote work opportunity

Job Summary

The medical billing and Medicare specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments, and collections of Medicare. The specialist must demonstrate proficiency with billing systems to ensure all functionalities are utilized for efficient claims processing.

Responsibilities

1. Correct, complete, and process claims for all payer codes.
2. Analyze and interpret claims to ensure accuracy before sending to insurance companies.
3. Follow up with Medicare on unpaid insurance accounts identified through aging reports.
4. Process appeals online or via paper submission.
5. Assist with billing audit-related information.
6. Identify trends and issues related to billing and reimbursements; report findings to supervisor.
7. Manage A/R collection opportunities on unpaid claims.
8. Maintain productivity and quality standards while managing tasks to ensure timely resolution of reports.
9. Use resources such as payor websites, analytics, and correspondence to accomplish tasks.
10. Obtain claim payment status, amount, and date from insurance companies based on aging thresholds.
11. Identify payment resolution steps when payments are not provided.
12. Escalate problematic claims to management with clear explanations.
13. Void invalid claims through payer portals or by mailing documentation.
14. File appeals and reconsideration requests for underpayments.
15. Review and submit notifications of overpayments.
16. Participate in A/R clean-up projects and other initiatives.
17. Take ownership of assignments and perform other duties as needed.
18. Communicate effectively with internal and external customers.
19. Interact cooperatively with team members and other departments.

Qualifications

• High School Diploma or GED.
• Experience with systems like Epic, SSI, Microsoft Excel, and Word (preferred).
• At least 2 years of hospital or physician office billing experience (preferred).

Skills and Abilities

• Effective verbal and written communication.
• Ability to work independently.
• Basic accounting and bookkeeping skills.
• Strong customer service skills.
• Knowledge of medical billing and terminology.