Accounts Representative – Payne Whitney Patient Accounts

Accounts Representative – Payne Whitney Patient Accounts

Requirements

• High school diploma or GED
• One year of related experience
• Proficiency with Microsoft Office software.
• Strong communication and customer service skills are essential to success.

Responsibilities

• Perform functions including insurance verification, inpatient billing, outpatient billing, self-pay collections, insurance follow-up, remittance processing.
• Obtain and verify insurance coverage by interviewing patients, families, and employers and by verifying coverage with insurance companies.
• Ensure that notifications, authorizations, pre-certifications are made, when appropriate.
• Assist self-pay patients in obtaining coverage for hospitalization, e.g., Medical applications, COBRA regulations.
• Secure promise of payments for patient for all non-covered services.
• Ensure that all patients are categorized correctly with regard to financial class, insurance company code, etc.
• Work with medical areas, e.g., Patient Case Management, physician’s offices, to ensure that requested clinical information is supplied timely.
• Receive and process information required submitting a third party bill.
• Ensure that bills are complete and comprehensive, e.g. correct form for ID numbers, comprehensives of hospital charges, validity of CPT-4, ICD-9, and HCPCS codes.
• Ensure that billing amounts are correct with regard to case payers, managed care providers with contracts, DRG’s day and cost outliners, implantable, exempt services, carve-outs, type of contract, services under NYPHRM, services under HCRA.

Preferred Qualifications

• Associate’s degree is preferred
• Two to four years of experience is preferred
• Our ideal candidate is also bilingual (English/Spanish)