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

St. Rose Hospital is seeking a Full Time Temporary Billing Specialist to ensure accurate, timely submission of Commercial/Managed Care UB04 claims.

The role focuses on resolving routine edits, maintaining collection activity, and escalating unresolved issues to management as needed. The ideal candidate will have hospital billing experience, knowledge of medical terminology, and familiarity with medical software.

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

• 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 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.
• Sets accurate follow up dates on account and maintains collections flow accordingly.
• Escalates the account both internally or at the payer when appropriate.
• Analyses any Commercial/Managed Care billing issues and provides examples of trends to Management.

Skills

Medical terminology

Medical software

Education

High School Diploma/GED or higher

Sexual Harassment/ Bullying Prevention Certification

Tools

Medical Software

Job description

Job Summary

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 escape claims at the payer when acceptable time frames exceeded.

Job description/Responsibilities

• 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

Experience

Minimum 1 Year

Job Family

Business and Financial Operations Occupations

Occupations

Business Operations Specialists, All Other

Degree Required

High School Diploma/Ged Or Higher