Patient Accounts Representative

nationwidechildrens; North Carolina; On-site; USD 36,000 - 48,000; Full time

Job summary

Nationwide Children’s Hospital is seeking a skilled Medical Billing Clerk to ensure accurate processing of patient accounts, charges, billings and follow-ups. You will review account information, perform necessary updates, and coordinate with payers to maximize reimbursement.

The role requires a high school diploma with two years in medical billing and claims follow-up, experience with CPT/ICD9 coding, and proficiency in Outlook, Word and Excel.

Qualifications

• High school diploma required; an associate degree preferred.
• Two years of medical billing and claims follow-up experience.
• Experience with CPT/ICD9 coding and payer reimbursement policies.

Responsibilities

• Review patient account information for completeness and accuracy.
• Make updates to patient account information to ensure timely payment.
• Retrieve status information from government and third-party payers.
• Coordinate with government agencies, third-party payers, and internal auditors to maximize reimbursement.
• Act as liaison between hospital and third-party payers in resolving billing and reimbursement issues.
• Provide follow-up on claim edits, rejections, denials, and outstanding claims.
• Maintain patient records and ensure confidentiality.

Skills

Medical terminology

Claims follow-up

Data entry

Problem solving

Communication skills

Organization

Microsoft Outlook

Microsoft Word

Microsoft Excel

Education

High school diploma

Associates degree preferred

Tools

Mainframe computer

Microsoft Excel

Microsoft Word

Outlook

Job description

Overview

Schedule: Monday-Friday (Day Shift)

Fully on-site during probation period until approved to work hybrid.

Job Description Summary

Responsible for the timely processing of duties and/or activities related to the accurate processing and handling of patient accounts. Ensures that all patient account information, charges, billings, and follow-up activities are accurate, complete, and timely.

Job Description

Essential Functions

• Reviews patient account information for completeness and accuracy.
• Makes necessary changes/updates to patient account information to ensure timely payment on accounts.
• Retrieves status information from government and third party payers regarding outstanding professional claims.
• Coordinates with governmental agencies, third-party payers, and internal auditors to ensure maximum reimbursement for hospital services.
• Acts as a liaison between the hospital and third party payers in resolving billing and reimbursement issues.
• Provides follow-up on claim edits, rejections, denials, and outstanding professional claims in a timely manner.
• Maintains patient records and ensures confidentiality of sensitive information.

Education Requirement

• High school diploma, required.
• Associates degree, preferred.

Licensure Requirement

(not specified)

Certifications

(not specified)

Skills

• Knowledge of medical terminology, various claim forms, third party contracts and payment patterns, CPT and ICD9 coding, and reimbursement regulations and policies of third party payers.
• The ability to do data entry and work a calculator.
• Problem identification and problem solving skills,required.
• Excellent interpersonal, verbal, and written communication skills.
• Excellent organization skills and the ability to comprehend and follow written and verbal instructions.

Experience

• Two years' experience in medical billing, claims follow-up and customer service, required.
• One year experience working on a mainframe computer.
• Experience using Outlook, Word and Excel, required.

Physical Requirements

• OCCASIONALLY: Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking
• FREQUENTLY: Flexing/extending of neck, Patient Equipment, Peripheral vision
• CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting
• Additional Physical Requirements performed but not listed above: (not specified)

Disclaimer

The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet