[Hiring] Associate Patient Access Representative @Community Health Network

Role Description

The Patient Account Representative is responsible for managing all aspects of accounts receivables to ensure maximum/timely reimbursement for services performed for hospital billing and claims. This position is customer focused with emphasis on accounts receivable management and will allow the flexibility to work from home upon completion of the initial training period.

• Keep current on all payer specific regulations and procedures.
• Provide written summaries of findings and recommendations.
• Follow established guidelines to recover delinquent accounts with the payers.
• Place calls to the payers to collect and assist in maintaining Network A/R days.
• Follow up via payer websites when appropriate.

Qualifications

• Two years or more years’ of experience in revenue cycle healthcare within a medium to larger healthcare system.
• Must be knowledgeable regarding payer billing guidelines.
• High School Diploma or GED required.

Requirements

• Adheres to all network and departmental procedures and policies.
• Complies with applicable state/federal laws and the program requirements of accreditation agencies and federal, state and government health plans.
• Documents all actions taken on accounts in the system account notes to ensure all prior actions are noted and understandable by others.
• Ensures confidentiality of patient records.
• Follows appropriate steps to resolve denials within specified timeframe.
• Follows appropriate steps to resolve insurance correspondence scanned into mail queues.
• Follows billing and collection procedures as outlined in policies and provides payers with the appropriate and necessary information to adjudicate claim.
• Maintains A/R to meet Network set goals.
• Meets productivity standards designated by the department.
• Meets QA standards designated by the department.
• Monitors the billing and follow up holds at all sources, ensures timely resolution and is responsible for keeping assigned tasks current.
• Participates in monthly conference calls with specific payers.