Patient Accounts Rep PCD

US-GA-Decatur
Employee Type
Full-Time
Department
619970 - Professional Services Billing Office
Shift
Day
Days of the Week for Employee
Monday - Friday
2701 North Decatur Road
Posted on Monster
No

Overview

PUSHING BEYOND
www.dekalbmedical.org
www.dekalbmedicalcareers.org


Five-Star Rated:

Recipient for Treatment of Heart Attack in 2013

Recipient for Treatment of Chronic Obstructive Pulmonary Disease in 2013

Award Winning Care:

Outstanding Achievement Award for Cancer Care (2007-2013)
Surgical Weight Loss Center of Excellence (2007-2013)
Sleep Disorders Center of Excellence
2010 Corporation of the Year- DeKalb Chamber of Commerce

Top Workplace in Healthcare:

Recognized by our Employees and The Atlanta Journal-Constitution as a 2011 Top Workplace
Voted by our Employees and Atlanta Magazine as a 2008 Best Place to Work

“Like” us on Facebook: www.facebook.com/DeKalbMedicalCareers
Follow us on Twitter: www.twitter.com/DeKalbMedicalHR

Responsibilities

JOB SUMMARY:

The Patient Account Representative is responsible for overall accounts receivable performance at assigned site(s). Works with patients to clear old balances and with managed care and insurance companies to ensure and maximize payments. Works EOBs, following up on denials. Shares information with providers and staff. Performs insurance verification. Knowledgeable about Medicare, Medicaid and Managed Care, competent on computerized patient information system, understands patient accounts, knowledgeable of CPT4, ICD9-CM, and HCPCS coding, and has excellent customer service skills.

 

JOB RESPONSIBILTIES:

Regularly reviews and works the accounts receivables aging reports to meet specialty specific benchmarks for Days in A/R.

Reviews Explanation of Benefits (EOBs), researches reasons for denial and makes appropriate follow-up.

Reviews patient balances and works with patients to achieve payment following the collection polices established with appropriate follow up with physicians for notification prior to patient being turned over to collections.

Works with the Practice Manager to answer billing questions in a timely manner.

Works with Practice Manager to ensure correct insurance information is obtained to ensure clean claims and minimize non-clinical denials. To include Navicure rejections, claim edit reports and unbilled encounters.

Works with Practice Manger to ensure maximum point of service collections.

Works with Practice Manager and Providers to process clinical claim denials. To include Navicure rejections, claim edit reports and unbilled encounters.

Works with Medicare, Medicaid, managed care companies and other insurance companies to determine status of claims in order to enhance collections in a timely fashion.

Works credit balance report monthly to ensure Medicare rule of 45 day is met.

Completes refund form on insurance credit balances and submits to the PSBO Manager for approval.

Completes paperwork received in the correspondence for patient bankruptcy or adjusts patient balance as appropriate.

Performs other duties as assigned to meet the goals and objectives of DeKalb Medical.

Participates in continuous quality improvement activities and teams.

Participates in supporting the organization’s vision, mission and values and adheres to DeKalb Medical Standards of Behavior.

Performs other duties as assigned to meet the goals and objectives of DeKalb Medical.

 

*Reports to: Physician Services Billing Office Manager

Qualifications

Minimum Education, Experience and Licensure Required:

  • High school diploma
  • Three (3) or more years of experience with claim edits/denials, working with EOBs, knowledge of CPT4/ICD9 coding

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