Patient Account Representative - Physician Claims

Patient Account Representative – Physician Claims

High School Diploma / GED or 3 years of relevant equivalent experience in lieu of Diploma / GED
0-2+ year’s experience in office, business, operations, customer service or healthcare field

Contacts third party payers and guarantors via payer websites or by phone to resolve account balances on all assigned accounts.
Work all correspondence within 24 hours or receipt. Detail notes regarding correspondence must be entered into the client’s system
Works all denials taking necessary actions to obtain account resolution
Submits appeals, as appropriate, for all non-clinical denials
Monitors all denials for trends and issues and reports findings to supervisor
Bills or re-bills claims as necessary
Ensures the client follows all state and federal rules and regulations both billing and HIPAA
Completes assigned special projects within the time frames given
Attend training sessions and seminars offered by the Client and Third-Party Payers.
Appropriately documents each account worked in client practice management system
Makes necessary corrections in client practice management system.
Resolves or forwards all address and / or plan changes as appropriate to ensure the integrity of the insurance master is maintained
Updates patient accounts with corrected demographic or insurance information
Posts adjustments based on standard operating procedures or as directed by leadership
Handles all customer calls both internal and external in a professional and courteous manner.

Previous experience working in insurance portals
PC skills in a Windows environment
Knowledge and utilization of desktop applications to include Word and Excel
Ability to initiate and follow through on projects and work independently with minimal supervision