JOB DESCRIPTION: As part of a team or works independently to resolve complex patient account issues. Obtains demographic and insurance information for pre-registration/registration on all patients. Collects and follows up on all accounts assigned prior to, during, or after admission and discharge. Communicates financial policies to all patients. Identifies patients who require early financial counseling intervention; provides information regarding resources for patients who need financial help.
Verifies, researches, and completes all paperwork and forms to bill all types of claims for reimbursement.
Serves as patient advocate during the cycle of the account. Responsible for accurate posting of insurance company and patient payments, including accurate contractual adjustments and denials.
Responsible for complete and accurate resolution of credit balance invoices through telephone, mail, and research efforts. Performs other related duties as required.
MINIMUM QUALIFICATION: High school diploma or equivalent. Two years collections, billing, and/or registration experience in a healthcare or insurance setting OR two years college/technical school and 1 year progressive experience. Certified Patient Accounts Representative (CPAR) and/or Certified Patient Financial Counselor (CPFC) preferred for positions in the hospital setting. Typing skills with a minimum of 35 wpm and good communication skills.
PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.