Patient Accounting Representative - Claims Processor

Halifax Staffing; Daytona Beach (FL); On-site; USD 42,000 - 56,000; Full time

Job summary

Halifax Staffing is seeking a Patient Accounting Representative - Claims Processor in Daytona Beach, FL. You will review, process, bill, and follow up on third-party payer claims, and pursue resources for timely payment.

You will communicate with payers and guarantors to resolve accounts and determine contractual adjustments. Candidates should have a high school diploma (associates or bachelor’s preferred) and at least two years in healthcare billing or hospital billing.

Qualifications

• Minimum high school diploma or equivalent; associate or bachelor’s preferred.
• At least two years of healthcare billing or hospital billing experience.
• Ability to communicate with patients while maintaining service standards.
• Experience with Meditech, Epic or EMR systems preferred.
• Proficient in general PC use.
• Strong oral and written communication skills.
• Process claims promptly and accurately per payer guidelines.
• Follow up on denied, rejected and pending claims.
• Knowledge of HCPC and UB04 coding where applicable.

Responsibilities

• Review, process, bill, and follow up on third-party payer claims.
• Pursue third-party resources in a persistent and timely manner.
• Communicate with payers/guarantors for timely resolution of accounts.
• Make determinations for contractual adjustments.
• Meet and/or exceed production goals as defined.
• Maintain and update billing and registration systems with revisions.

Skills

Healthcare billing

Customer service

Communication

Data entry

Education

High school diploma

Associates or Bachelor's preferred

Tools

Meditech

Epic

EMR systems

Job description

Day (United States of America)

Patient Accounting Representative - Claims Processor

Review, process, bill, and follow up on claims to third-party payers. Pursue third-party resources in a persistent and timely manner. Effectively communicate with payers/guarantors for timely resolution of accounts. Make appropriate determinations for contractual adjustments.

• Minimum high school graduate or equivalent required. Associates or Bachelor's degree from accredited institution is preferred.
• Minimum of two years experience in healthcare billing and/or business office setting, preferably in hospital billing.
• Must be able to communicate with patients effectively while maintaining customer service expectations.
• Preferred experience in Meditech, Epic and/or EMR systems.
• General PC knowledge in business setting is required.
• Must have good oral and written communication skills.
• Process insurance claims in a prompt and accurate manner, meeting all corresponding performance standards.
• Demonstrates the ability to evaluate and resolve accounts by utilizing resources including, but not limited to, bills, remittances, correspondence, worklist and insurance calls in accordance to payer specific guidelines in a timely manner.
• Corrects and processes rejected, and hardcopy claims in a timely manner.
• Demonstrates proficiency in the billing systems and accounts receivable systems, keeping abreast of all changes.
• Maintains current knowledge of HCPC and UB04 coding in accordance with specific insurance payer guidelines.
• Assigns appropriate dates to follow up with insurance carrier to ensure prompt payment.
• Updates billing and registration systems with any demographic/insurance revisions the same day received.
• Follows up on all denied, rejected and/or pending claims in a timely manner, utilizing all electronic means available.
• Maintains ability to bill specialty accounts which include, but not limited to, cycle bills, audit bills, split bills, DME, carve-outs, in-house denials, SDS, etc.
• Analyze and follow up on any late charges credited or debited on accounts in accordance with established guidelines.
• Ensure account information is current by entering notes, documentation and changes at time of occurrence.
• Research and determines required adjustment information as deemed necessary in accordance with insurance payer.
• Obtains and supplies insurance carriers with necessary account information to expedite payment.
• Meets and/or exceeds production goals as defined.
• Contributes to effective working relationships by demonstrating a positive and helpful attitude in relationships with coworkers and customers.

Duties as assigned