Patient Account Representative
United Musculoskeletal Partners
full-time
Posted on:
Location Type: Remote
Location: United States
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About the role
- Expedite and maximize payment of insurance medical claims by contacting third-party payors and patients including resubmission of claims, corrected claims, appeals, etc.
- Complete post service denial tasks in accordance with established productivity and performance standards.
- Collaborate with management in developing a plan to reduce aging of accounts with efficiency and maximum results.
- Effectively communicate and collaborate with management to determine escalation of denied claims.
- Identify claims processing issues upstream for denial prevention.
- Demonstrate the expertise of all payors, including Medicare, Medicaid, and commercial payors.
- Assist with knowledge sharing, payor, and department training, and provide support to other team members as advised by the manager and/or supervisor.
- Identify, analyze, and escalate trends impacting AR collections.
- Execute special projects to improve AR performance, as assigned.
Requirements
- Three years physician billing experience, preferably in a large orthopedic physician practice.
- Knowledge of EMR (Electronic Medical Record) (athenahealth preferred).
- Ability to critically think through next steps on at risk accounts and resolve with optimal outcome.
- Ability to prioritize workload for maximum benefit on aging accounts and to ensure that accounts do not age out beyond timely filing limits.
- An ability to identify upstream blockers, prioritize solutions and communicate effectively.
- Excellent communication and influencing skills; proven experience of influencing other teams/groups where their support is critical to success.
- In-depth knowledge of CPT-4, ICD-10 and HCPCS coding, along with CCI edits.
- Must have a comprehensive understanding of insurance pre-certification requirements, contract benefits, and medical terminology.
- Managed care knowledge with the ability to differentiate between insurance plans such as Preferred Provider Organization (PPO), Point of Service (POS), Health Maintenance Organization (HMO), etc.
- Ability to effectively communicate with physicians, clinic staff, patients, and co-workers consistent with a customer service focus and application of positive language principles.
- In depth knowledge of third-party payer reimbursement policies and procedures.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
physician billingCPT-4 codingICD-10 codingHCPCS codingCCI editsinsurance pre-certificationmedical terminologythird-party payer reimbursementEMRclaims processing
Soft Skills
critical thinkingprioritizationcommunicationinfluencingcollaborationproblem-solvingcustomer service focusknowledge sharingteam supportescalation management