Patient Accounts Representative - Patient Accounts
Nationwide Children’s Hospital
- Columbus, OH
- Permanent
- Full-time
- Completes accurate hard copy and electronic billing for all patients accounts and submits the billing within 48 hours of Final Bill to the appropriate payer.
- Bills secondary and tertiary payers within 5 days of a primary payers payment.
- Processes late charges within 5 days of receipt.
- Performs collection activity on accounts.
- May use Worklists for followup or daily denial reports. Each one uses different criteria for selection of accounts to work.
- Researches, analyzes claims paid incorrectly and resolves for restitution.
- Reviews payer rejections and makes corrections to resubmit claim as needed or bills the parent within 5 days or the rejection.
- Initiates and processes all adjustments for third party payers within 5 days of request and documents the accounts as appropriate.
- Works with internal auditor on third party payer audits to ensure coordination of efforts and maximum collection. Coordinates activities resulting from audit.
- Coordinates claim and financial appeal information with governmental agency and third party payers to ensure maximum reimbursement for hospital services.
- Identifies payer problems and initiates recommendations for solution to supervisor.
- Acts as a liaison between the hospital and third party payers in resolving billing and reimbursement issues.
- Attends conferences and inservices to stay up to date in knowledge of payer requirements and regulations for billing and reimbursement and incorporate data learned into the work being processed.
- Serves on and contributes to various task forces within the department and/or hospital.
- Maintains knowledge base to provide coverage for other areas when needed.
- Performs other related duties as assigned.
- High school diploma or GED, Associates degree preferred.
- Minimum of 2-3 years experience in medical billing, claims follow-up and customer service.
- Knowledge of medical terminology, various claim forms, third party contracts and payment patterns, CPT and ICD9 coding, and reimbursement regulations and policies of third party payers.
- The ability to do data entry and work a calculator.
- One year experience working on a mainframe computer. Experience using Outlook, Word and Excel.
- Problem identification and problem solving skills are required.
- Excellent interpersonal, verbal, and written communication skills.
- Excellent organization skills and the ability to comprehend and follow written and verbal instructions.