Patient Account Representative - Patient Accounting (Billing and Collection) -18

St. Rose Hospital; Hayward (CA); On-site; USD 40,000 - 47,000; Full time

Job summary

Smart Hires Corporation is seeking a Patient Account Representative for the Patient Accounting (Billing and Collection) team. This is a full-time role with a 40-hour AM shift, paying approximately $28.76-$34.34 per hour.

Responsibilities include accurate submission of UB04 claims, routine billing edits, and proactive follow-up on Commercial/Managed Care accounts to maximize collections. Requires high school diploma and hospital billing experience.

Qualifications

• High school graduate or equivalent preferred
• Two years experience preferred in Hospital Billing, Collection or Customer Service preferred
• Sexual Harassment/ Bullying Prevention Certification required. (1 month from hire)
• Prior experience with Medical Software preferred
• Knowledge of medical terminology

Responsibilities

• Provides accurate, timely and compliant submission of all Commercial/Managed Care UB 04 claims for St. Rose Hospital System.
• Resolves routine billing edits and escalates unresolved edits to appropriate department for resolution.
• Manages follow up and collections on Commercial/Managed Care accounts to maximize collections.
• Documents collection activity to ensure correct steps for timely payment as per payer contracts.
• Escalates claims to payer when acceptable time frames exceeded.

Skills

Billing experience

Medical terminology

Customer service

Payer follow-up

Education

High School Diploma/GED

Job description

Patient Account Representative - Patient Accounting (Billing and Collection) -18

Position Id

STROS737191

Job Organization

Job Type

1 Regular/Full timeJobs

Status

Active

Hours

Job Location

Job summary

Job description/Responsibilities: Full Time Temporary - 40 hours AM Shift

APPROXIMATE PAY RANGE:$28.76 - $34.34

JOB SUMMARY:Provides accurate, timely and compliant submission of all Commercial/Managed Care Uniform Bill [UB] 04 claims for St. Rose Hospital System. Resolves routine billing edits and escalates all unresolved edits to appropriate department for resolution. Manages follow up and collections on Commercial/Managed Care accounts in a manner that ensures optimal collections and account resolution for St. Rose Hospital. Documents collection activity on accounts thoroughly to ensure correct sequential steps are taken to obtain payment within acceptable time frames according to payer contracts. Ability to escalated claims at the payer when acceptable time frames exceeded.

• Reviews and prepares claims to release the same day as received in work queue.
• Follows compliant Billing practices for all Commercial/ Managed Care payers.
• Researches and forwards billing edits/errors for correction[s] to appropriate area/department the same day as identified.
• Monitors and escalates all unresolved claim edits within 3-5 days to Management.
• Monitors untimely claims to ensure timely filing limits are met.
• Verifies claim status through Payer website or via phone in accordance with age/balance follow up criteria set by Patient Accounts Management.
• Documents account thoroughly to include accurate status information. Work should consistently drive the account towards timely resolution. Insurance demographics including phone number, representative?s name and claim number should be included in each note.
• Sets accurate follow up dates on account and maintains collections flow accordingly.
• Escalates the account both internally or at the payer when appropriate. In addition notifies Management of any issues that prevent timely collection of claim payments.
• Analyzes any Commercial/Managed Care billing issues and provides examples of trends to Management.

Required Qualification:

• High school graduate or equivalent preferred
• Two years experience preferred in Hospital Billing, Collection or Customer Service preferred
• Sexual Harassment/ Bullying Prevention Certification required. (1 month from hire)
• Prior experience with Medical Software preferred
• Knowledge of medical terminology

Job Family:Business and Financial Operations Occupations

Occupations:Business Operations Specialists, All Other

Degree Required:High School Diploma/Ged Or Higher