Patient Accounts Representative

10 Nationwide Children's Hospital; United States; On-site; USD 42,000 - 60,000; Full time

Job summary

Nationwide Children’s Hospital is seeking an experienced patient accounts specialist to ensure accurate processing of accounts and timely follow-up on claims. You will review and update patient information, coordinate with payers, and support auditors to maximize reimbursement while maintaining patient confidentiality.

The role requires at least two years in medical billing and proficiency with Outlook, Word, and Excel, with high attention to detail and strong communication skills.

Qualifications

• 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.
• 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.

Responsibilities

• Reviews patient account information for completeness and accuracy.
• Makes changes/updates to patient account information to ensure timely payment.
• 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.
• 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.

Skills

Medical terminology

Claim forms

Third party contracts

CPT/ICD9 coding

Reimbursement regulations

Data entry

Problem solving

Communication skills

Organizational skills

Education

High school diploma

Associates degree preferred

Tools

Outlook

Word

Excel

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

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

Why join us

The moment you walk through our doors, you feel it. When you meet our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it. Welcome to Nationwide Children’s Hospital, Where Passion Meets Purpose. Here, Diversity, Equity and Inclusion are integrated into our core values and practices. We are passionate about building, sustaining and evolving an inclusive and equitable environment. We’re seeking individuals who live these values and want to share their experiences and efforts in support of our collective mission. We’re 15,000 strong. And it takes every one of us to improve the lives of the kids we care for, and the kids around the world we’ll never meet. Kids who live healthier, fuller lives because of the knowledge we share. We know it takes a Collaborative Culture to deliver on our promise to provide the very best, innovative care and to foster new discoveries, made possible by the most groundbreaking research. Anywhere. Ask anyone with a Nationwide Children’s badge what they do for a living. They’ll tell you it’s More Than a Job. It’s a calling. It’s a chance to use and grow your talent to make an impact that truly matters. Because here, we exist simply to help children everywhere. Nationwide Children’s Hospital. A Place to Be Proud.