Veterans in Healthcare · 2 months ago
Accounts Receivable Billing Representative - PRN Weekdays - Hybrid
Gainesville, GA
Part-time
Hybrid
Entry, Mid Level
2+ years expVeterans in Healthcare is dedicated to improving the health of communities through their services. The Accounts Receivable Billing Representative is responsible for managing unpaid or denied claims and providing excellent customer service to patients and staff.
Health CareMilitary
Responsibilities
Maintains current knowledge of third party, federal and state regulations, insurance coverage, rejection codes and billing requirements related to physician billing and follow-up. This is to be accomplished by attending related seminars, research, meeting with insurance reps and reading all memos/payer updates
Ensures secondary billing on accounts with secondary liability; follow-up on any unpaid balances
Provides corrected data and resubmit claims as necessary
Responds to patient and third party inquiries/complaints regarding patient accounts via telephone, mail or in person
Maintains/improves productive third party relationships
Ensures that denied visits/services are appealed or processed to be written off if applicable
Reports possible write-offs to Practice/Billing Manager
Works closely with other billing personnel and Practice/Billing Manager in following up on accounts
Reviews/analyzes patient accounts and take needed actions to resolve patient issues by executing adjustments, refunds, etc. from incoming/outgoing telephone calls or mail
Provides the highest-level customer service to patients and other CBO or center staff by following through on phone calls, site questions/concerns and account inquiries. Resolve patient complaints and requests regarding insurance billing and initiate accurate account adjustments
Updates demographic and insurance information on patient accounts as needed
Keeps others in Central Business Office informed of third-party billing updates, documentation guidelines, and reimbursement/ contract administration
Serves as a liaison with payers, collection agencies and patients by being available to answer questions, handle situations as they occur and meet with insurance reps regularly
Follows all billing problems to conclusion
Resubmits insurance claims as required
Ensures the integrity and timeliness of workflow by making sure work is turned in as assigned as well as follow-up on the progress and documentation of account load
Collects and review all patient insurance information needed to complete the billing process
Completes all necessary insurance forms (i.e. HCFA 1500) to process the proper billing information in a timely manner as required by all third party payers
Submits all paper claims and supporting documentation as required by payers
Works CBO reports in a timely manner and turn in to Supervisor/Manager on designated dates. Reports must be completed along with putting notes in the system, follow-up as needed and awareness to reducing the over 90 (+) days aging buckets
Reports any problem, concerns, trends or issues with Supervisor/Manager by monitoring accounts
Maintains updated resource manuals and related materials
Ensures integrity, confidentiality and security of patient records
Assists center Practice Administrators in reimbursement issues
Helps to maintain overall cleanliness and safety of workplace in the business office
Promotes excellence in patient relations and customer service, emphasizing compassion, responsiveness, respect and courtesy
Reviews credit balance and overpaid insurance reports as assigned. Identifies sources of overpayment and ensures appropriate refund processing or account correction
Researches all credit balance accounts and identifies source(s) of overpayment
Enters refund transaction detail into appropriate system to accurately reflect approved transaction
Asks questions to determine patient needs
Uses active listening skills, getting information and summarizing to check understanding
Looks for opportunities to exceed patient’s expectations by acting promptly, involving patient where solutions are needed
Confirms patient’s satisfaction with service or course of action and commit to follow-through
Works harmoniously with others, demonstrating a commitment to achieving common goals
Responds positively to work-related requests from others
Communicates in a manner that promotes trust and mutual respect
Qualification
Required
High School Diploma or GED
Two (2) years of experience in Medical Physician billing, collections and/or reimbursement to include authorizations, charge entry, claims management, payment posting and accounts receivable
Thorough knowledge and understanding of patient billing, billing transmission and electronic billing systems, including reimbursement knowledge of Medicare, Blue Cross, United Health Care, Medicaid, commercial insurance and HMO carriers
Knowledge of medical terminology and ICD-9/CPT coding. Demonstrate competency in coding CPT and ICD9 related to reimbursement
Strong written and oral communication skills including the ability to work with other departments. Demonstrate positive interpersonal relations in dealing with fellow employees, Supervisors, Physicians, Management so that productivity and positive employee relations are maximized
Ability to interpret third party coverage, patient responsibility and evaluate a patient's financial condition
Knowledge of processes for billing professional services provided in the hospital and office setting. Knowledge of the appeals processes for different payers
Knowledge of electronic billing systems and EMR's
Ability to work and resolve problems independently and demonstrate task completion
Demonstrate thorough knowledge and understanding of CBO Policies and Procedures as well as the NGHS handbook
Demonstrate thorough understanding of Medicare and commercial waivers if pertinent to job
Demonstrate competency in use and maintenance of computer equipment, printers, and telephone system and facsimile machines. Understand basic PC window applications
Maintains current knowledge of third party, federal and state regulations, insurance coverage, rejection codes and billing requirements related to physician billing and follow-up
Ensures secondary billing on accounts with secondary liability; follow-up on any unpaid balances
Provides corrected data and resubmit claims as necessary
Responds to patient and third party inquiries/complaints regarding patient accounts via telephone, mail or in person
Maintains/improves productive third party relationships
Ensures that denied visits/services are appealed or processed to be written off if applicable
Reports possible write-offs to Practice/Billing Manager
Works closely with other billing personnel and Practice/Billing Manager in following up on accounts
Reviews/analyzes patient accounts and take needed actions to resolve patient issues by executing adjustments, refunds, etc. from incoming/outgoing telephone calls or mail
Provides the highest-level customer service to patients and other CBO or center staff by following through on phone calls, site questions/concerns and account inquiries
Updates demographic and insurance information on patient accounts as needed
Keeps others in Central Business Office informed of third-party billing updates, documentation guidelines, and reimbursement/ contract administration
Serves as a liaison with payers, collection agencies and patients by being available to answer questions, handle situations as they occur and meet with insurance reps regularly
Follows all billing problems to conclusion
Resubmits insurance claims as required
Ensures the integrity and timeliness of workflow by making sure work is turned in as assigned as well as follow-up on the progress and documentation of account load
Collects and review all patient insurance information needed to complete the billing process
Completes all necessary insurance forms (i.e. HCFA 1500) to process the proper billing information in a timely manner as required by all third party payers
Submits all paper claims and supporting documentation as required by payers
Works CBO reports in a timely manner and turn in to Supervisor/Manager on designated dates
Reports any problem, concerns, trends or issues with Supervisor/Manager by monitoring accounts
Maintains updated resource manuals and related materials
Ensures integrity, confidentiality and security of patient records
Assists center Practice Administrators in reimbursement issues
Helps to maintain overall cleanliness and safety of workplace in the business office
Promotes excellence in patient relations and customer service, emphasizing compassion, responsiveness, respect and courtesy
Reviews credit balance and overpaid insurance reports as assigned. Identifies sources of overpayment and ensures appropriate refund processing or account correction
Researches all credit balance accounts and identifies source(s) of overpayment
Enters refund transaction detail into appropriate system to accurately reflect approved transaction
Asks questions to determine patient needs
Uses active listening skills, getting information and summarizing to check understanding
Looks for opportunities to exceed patient's expectations by acting promptly, involving patient where solutions are needed
Confirms patient's satisfaction with service or course of action and commit to follow-through
Works harmoniously with others, demonstrating a commitment to achieving common goals
Responds positively to work-related requests from others
Communicates in a manner that promotes trust and mutual respect
Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time
Weight Carried: Up to 20 lbs ,Occasionally 0-30% of time
Vision: Moderate, Frequently 31-65% of time
Kneeling/Stooping/Bending: Occasionally 0-30%
Standing/Walking: Occasionally 0-30%
Pushing/Pulling: Occasionally 0-30%
Intensity of Work: Frequently 31-65%
Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding
Preferred
CPC certification
Company
Veterans in Healthcare
Veterans in Healthcare is a comprehensive source of career information and opportunities for military personnel transitioning.
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase