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Sr. Patient Accounts Rep - Patient Accounting - Days
at Women's Hospital
Review assigned A/R to analyze and resolve a variety of complex billing issues. Works closely with doctors and their staff, governmental agencies, managed care companies, third party insurance companies and various departments such as Health Information Management, QA, Lab, Radiology, and the hospital clinics in order to resolve billing/reimbursement issues in a professional and efficient manner. Needs to understand the Meditech system data flow as relative to bill/claim generation in order to reconcile system adjustments applied to each patient bill, which has a direct impact on hospital revenue. Responsible for understanding all aspects of Medicaid/Medicare billing in order to file claims with all appropriate revenue, CPT4, and HCPCS codes.
Works closely with the QA department regarding authorization needed to file all claims, especially newborn neonates. Takes appropriate action steps to resolve patient/coworker/management requests and refile corrected/adjusted claims. Works with the claims processors to ensure claims are validated properly so claim will process without manual intervention.
Responsible for reviewing and making necessary contractual adjustments to patient accounts according to Medicaid/Medicare payment methodology. Quickly bring any trends in the industry that may cause a negative financial impact to Woman's Hospital to the Patient Billing Manager. Responsible for working assigned A/R in order to bring account closer to completion, including refiling claims, appealing any inappropriate reimbursements and/or denial decisions and sending patients appropriate letters. Dials into Medicare billing system in order to work assigned claims and takes appropriate actions for claims to be processed. Performs other duties as assigned by department management according to policies and procedures and the mission of Woman's Hospital.
$14.18 - $20.03