Patient Account Associate I

Patient Account Associate I

Requirements

• High School Diploma or equivalent (GED)
• One (1) years of experience in hospital or physician insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections)
• Knowledge of Medicaid and Medicare billing regulations

Responsibilities

• Responsible for the timely follow-up of claims billed and resolution of accounts
• Oversees the account receivables and maintains detailed/accurate account documentation
• Follow up on open claims thoroughly, accurately, promptly, and with all supporting documentation
• Responsible for maintaining and updating billing guidelines, fee schedules, contract rates, etc.
• Review, document, and resolve all incoming correspondence and payor calls
• Assist as needed on aging reports
• Report all payor issues and/or denial trends to Lead/Supervisor
• May appeal and/or rebill underpaid claims and assist with payments, as needed
• Maintain basic understanding and knowledge of health insurance plans, policies and procedures
• Research and follow-up on outstanding claims
• Appropriately document in the system all correspondence and action for the claim
• Follow up in accordance with procedures and policies with an overall goal of account resolution
• Contact insurance companies to obtain information necessary for invoice or account resolution through write-offs, reversals, adjustments or other methods
• Identify issues and/or trends and provide suggestions for resolution to management, including payer, system or escalated account issues
• Research medical records to gather information and substantiate medical justification for procedures as required by insurance carriers
• Submit requested medical information to insurance carrier
• Responsible for the analysis and necessary corrections of invoices or accounts and maintaining work queues
• Responsible for meeting or exceeding productivity and quality goals

Preferred Qualifications

• Knowledge of Revenue and ICD coding language
• Two (2) years of experience in hospital or physician insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections)