Patient Accounts Representative

Description

The person in this role may act in either all, one, or some of the following functionalities: Coding, Posting, Claim Resolution, or Benefits Coordination. All functions perform highly technical and specialized functions for the patient financial services department. Persons in this role may be responsible for assisting in new hire training. The person in this role must maintain patient confidentiality and adhere to all policies and procedures as outlined in Employee Handbook or departmental guidelines.

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Claims Resolution:

• Reviews reports (aged trial balance, aging reports, etc.) to ensure timely follow-up and resolution of accounts for assigned payors.
• On a daily basis, researches and corrects denials received for assigned clients.
• Documents all correspondence with patients, insurance carriers and clients.

 

Benefits Coordination: 

• Working Clearwave system to accurately display correct insurance for claim filing
• To ensure all services for MEC have appropriate insurance benefit coverage as well as authorization and notification in place prior to all outpatient elective\non-elective scheduled services and within contractual guidelines for urgent and emergent services. 
• Responsible for completing work lists timely. 

Qualifications

• :Minimum of one year experience in a hospital admitting/registration practices insurance and managed care areas
• High school diploma or GED. 
• Healthcare Experience preferred