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McLeod Health · 17 hours ago

Billing Account Representative - Florence & Myrtle Beach

South Carolina, United States

Full-time

Onsite

Mid Level

3+ years exp

McLeod Health is a not-for-profit organization with a long history of healthcare service. They are seeking a Billing Account Representative responsible for managing claims, ensuring accurate billing, and following up with third-party payers to secure payments.

CommunitiesHealth CareHospitalMedical

H1B Sponsor Likely

Responsibilities

Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values

Responsible for efficient and effective follow-up on third party payers to determine why payment has not been received within a specified amount of time

Reviews and interprets payer remittances for the purpose of verifying accuracy of payments, adjustments and to determine appropriate action to be taken on denied claims, per guidelines

Initiates appeals for denied claims per payer guidelines

Reviews patient account files as necessary for accuracy of information, necessary signatures, pre-certification, insurance benefits, and deposits made

Submit electronic and hard copy claims in an accurate and timely manner and makes all necessary corrections to the claims that do not pass the billing edits and payer requirements

Contact payers for status of unpaid claims and research to ensure that questions and requests for information are addressed in a timely and professional manner to facilitate resolution and reimbursement

Assure timely, effective, and thorough management of claims to ensure full, expected reimbursement for services provided

Reviews and resolves credit balances in an accurate and timely manner according to policy

Obtain patient payments and/or set up payment plans according to policy and document any payment arrangements on patient account. Prepares accounts with outstanding balances for the collection agency

Understands and complies with processes for corrected claims, per payer guidelines

Maintains knowledge of payor guidelines for assigned specialties

Prioritize claims based on aging and outstanding dollar amounts or as directed by management

Answer telephone calls from patients and other callers promptly and with courtesy, demonstrating service excellence as a top priority

Communicates payer trends or problems identified as impacting reimbursement to the management team

Manage their time to meet collection goals and productivity standards as defined by the management team

Participates in quarterly AR meetings with the assigned Medical Practices and educational sessions

Ability to look up ICD-10 and CPT Treatment codes from online service or using traditional coding reference

Regularly meets with the Billing Manager to discuss and resolve reimbursement issues or billing obstacles

Travel may be required to off-site locations at times

Demonstrates the ability to work independently and prioritize a heavy workload in a fast paced environment. Strong emotional maturity. Strong time management, organizational and written/verbal communication skills. Must have strong problem solving, attention to detail and accuracy skills. Proficiency in Microsoft Word, Outlook and Excel. Proficiency in Math and Medical Terminology. Ability to maintain highly sensitive and confidential information

Qualification

Claims ManagementInsurance BillingICD-10 CodingCPT CodingMicrosoft ExcelMedical TerminologyTime ManagementOrganizational SkillsProblem SolvingCommunication Skills

Required