[Hiring] Patient Account Representative 1 @Oregon Health & Science University

Role Description

This position will bill, process adjustments, collect on accounts, and/or perform customer service duties to ensure that monies due University Hospital are secured and paid in a timely manner and the AR outstanding days of revenue are kept to a minimum. Assignment will be flexible depending on payor mix, patient flow, and workload fluctuations.

Qualifications

• Two years of recent (within the last 5 years) experience billing or collecting healthcare accounts in a business office; OR
• Four years of general collection, billing or customer service experience; OR
• Equivalent combination of education and experience.
• Certified Revenue Cycle Specialist (CRCS) is required within 18 months of hire.

Requirements

• Submit bills that comply with all appropriate regulations, managed care contracts to third party payors.
• Calculate the correct reimbursement of all managed care claims.
• Collect assertively and proactively money due OHSU by contacting third parties (insurance carrier, various government programs, etc.).
• Provide explanation of charges and additional requested information to the third parties.
• Analyze accounts to determine coordination of benefits, refunds, and denials to ensure appropriate resolution of accounts.
• Review billing to determine medical records necessary to provide complete processing of claim.
• Analyze accounts with regard to billing and payment history and use judgment to determine appropriate follow-up action based on departmental guidelines.
• Contact patient/guarantor to resolve issues (includes tracing and locating patient/guarantor by telephoning and/or sending written correspondence).
• Analyze accounts and interpret contracts that dictate how claims should be paid and process adjustments for contract interpretation.
• Comply with special billing and follow-up requirements regarding adoptions, court holds, motor vehicle and personal injury accidents, and other unique or sensitive accounts.
• Work reports of denied claims to trend and report these claims to the department and to our front end partners.
• Work closely with admitting, care management and ambulatory services on the denied claims for resolution and feedback purposes.
• Other duties as assigned, including activities that are classified as team support and environmental activities.

Benefits

• Healthcare for full-time employees covered 100% and 88% for dependents.
• $50K of term life insurance provided at no cost to the employee.
• Two separate above market pension plans to choose from.
• Vacation - up to 200 hours per year dependent on length of service.
• Sick Leave - up to 96 hours per year.
• 9 paid holidays per year.
• Substantial Tri-Met and C-Tran discounts.
• Employee Assistance Program.
• Childcare service discounts.
• Tuition reimbursement.
• Employee discounts to local and national businesses.