Hunter Hamilton Looking for Patient Account Representative at Lees Summit, MO Full Time

The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. This candidate should have a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment. Representative will need to effectively follow-up on claim submission, remittance review for insurance collections, create and pursue disputed balances from both government and non-government entities. Basic knowledge of Commercial, Managed Care, Medicare and Medicaid insurance is preferable. An effective revenue cycle process is achieved with working as part of a dynamic team and the ability to adapt and grow in an environment where work assignments may change frequently while resolving accounts with minimal assistance.

Team member should possess the the following:

• Basic computer skills to navigate through the various system applications provided for additional resources in determining account actions
• Access payer websites and discern pertinent data to resolve accounts
• Utilize all available job aids provided for appropriateness in Patient Accounting processes
• Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account
• Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership
• Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities
• Provide support for team members that may be absent or backlogged

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Researches each account using company patient accounting applications and internet resources that are made available
• Conducts appropriate account activity on uncollected account balances with contacting third party payors and/or patients via phone, e-mail, or online
• Problem solves issues and creates resolution that will bring in revenue eliminating re-work
• Updates plan IDs, adjusts patient or payor demographic/insurance information, notates account in detail, identifies payor issues and trends and solves re-coup issues
• Requests additional information from patients, medical records, and other needed documentation upon request from payors
• Reviews contracts and identify billing or coding issues and request re-bills, secondary billing, or corrected bills as needed
• Takes appropriate action to bring about account resolution timely or opens a dispute record to have the account further researched and substantiated for continued collection

Qualifications:

KNOWLEDGE, SKILLS, ABILITIES

• Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections) procedures and policies
• Intermediate skill in Microsoft Office (Word, Excel)
• Ability to communicate in a clear and professional manner
• Must have good oral and written skills
• Strong interpersonal skills
• Above average analytical and critical thinking skills
• Ability to make sound decisions
• Has a full understanding of the Commercial, Managed Care, Medicare and Medicaid collections, Intermediate knowledge of Managed Care contracts, Contract Language and Federal and State requirements for government payors
• Familiar with terms such as HMO, PPO, IPA and Capitation and how these payors process claims
• Intermediate understanding of EOB

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.
• High School diploma or equivalent. Some college coursework in business administration or accounting preferred
• 1-4 years medical claims and/or physician/ hospital collections experience