Job Description

BASIC PURPOSE OF THE JOB

Responsible for accurate billing and collections of Physician Receivables. Gives feedback to team lead on ways to improve daily processes and improve collections. Able to work in a team environment and problem solve. Ensures clean claims and timely follow up of claims with insurance companies.

REPORTS TO

RBO Lead Patient Account Representative

JOB REQUIREMENTS

Supervisory Responsibilities: NO

Minimum Education: High School Diploma/GED Preferred

License/Certification Required: None

Minimum Work Experience: Physician billing and collection experience preferred

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

Excellent customer services skills and ability to work with a team required. Familiar with rules and regulations of CMS/Tenncare and other payers to ensure proper collection of insurance data to finalize claims for proper billing and to proper payer on first claim submission. Excellent typing stills. Ability to work with insurance companies to ensure timely payment of claims. Problem solving stills and multi tasking required.

DUTIES AND RESPONSIBILITIES

Answers incoming telephone call in a courteous and helpful manner: Calls are answered timely and families are given a response within 24 hours as observed by management. Takes initiative on the call to settle any disputes when possible. Always ends conversation with family with “is there anything else I can do for you today". Answers inquiries and requests; completes or refers call to the appropriate contact.
Relays complete, detailed messages and information to the appropriate individuals, while marinating confidentially of all information. Works collection desktop to ensure that claims are worked in a time sensitive nature in ore to reduce/eliminate timely filling errors.
Works with office manager to retrieve necessary information for complete claim processing. Processes claims for hold and collection status. Verifies and edits patient/subscriber information in computer system.
Reviews procedure codes and diagnoses codes on rejected claims and assists office with corrections. Works all insurance rejections on the day they are received in a timely manner.
Offers long term solutions for repeat issues. Appeals denials as needed.
Communicates electronically with payer when possible to ensure proper audit trail to prove timely and dispute any improper response with account representative etc.
Documents accounts properly.
Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
Interacts with all patients and staff in a considerate and help manner as observed by management and peer input. Maintains professional composure and confidence during stressful situations.
Maintains confidentiality of all hospital and patient information at all times as observed by management and peers. Does not discuss any patient information in public areas. Does not discuss any patient with friends or family who may call to ask about child who has been here. Only discusses patient accounts after HIPAA information has been verified in system. Only accesses accounts needed to complete resolution of the account. Cannot access friends’ or family’s accounts. Refers any accounts you feel should not be accessed by you to your team leader, neighbor, in-law issue etc. for reassignment.
Continuously displays a “can do” attitude within the practice and across other departments lines to contribute to the overall focus on service excellence.
Completes all Children’s Hospital and practice required training and CBL requirements.
Attends all educational programs as needed.
Maintains a safe and clean work area. Practices safe lifting and body mechanics.
Willingly accepts any other assignment that may be requested.
Utilizes hospital resources and time respectfully and accountably.
Works as efficiently as possible to ensure best use of time.

PHYSICAL REQUIREMENTS

Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position.
Light lifting, pushing and pulling is required for 10-20 lbs occasionally and frequent moving of objects of less than 10 lbs is required. Frequent sitting with some walking, standing, squatting, bending and reaching is required. Keyboard/computer use and/or repetitive motions may be required.

Come work where you can make a difference everyday.

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