Patient Accounts Associate
Peoria Metro Area, IL 61601
Primary Job Responsibilities
Demonstrates excellent service to all patients and family members by ensuring incoming calls and correspondence are processed expeditiously. Addresses billing questions and ensures appropriate resolution of problems.
Maintains knowledge of current regulatory and payor requirements for claims submission and applicable guidelines for appeal of adverse payment determinations
Collects updated information from patients, payors, and other departments in order to maintain an accurate patient record ensuring prompt accurate claim submission and payment.
Works with other departments to appropriately contribute to account resolution and manage receivables.
Reviews payor, patient, or other correspondence to ensure accounts are maintained up to date.
Navigates EMR in order to identify and retrieve information to escalate and appeal claims. This information may be scanned documents, registration information, charge data or account notes.
Review and update registration elements. This includes insurance cards, coverages, plan codes, and patient and guarantor demographics.
Review account billing information for payments and adjustments to ensure account balances are assigned to the proper payor or patient accordingly. Review and interpret claim/remittance information in order to clearly determine appropriateness of payments and adjustments.
Recognize when account issues are present and demonstrates the appropriate actions to ensure account resolution. Actions may require relocating payments to address credits or support rebilling, update account in order to initiate rebill, or move account to an escalation.
Efficiently manages assigned work queues to ensure timely resolution of accounts. Work queue management requires knowledge in follow-up guidelines, work queue routing rules, steps to account completion or transfer to necessary escalations.
Education Completion of high school or its equivalent.
Experience Minimum of one year in an office clerical setting or customer service environment.
Experience with office applications and Internet.
Licensure/Certifications It is required to complete all required revenue cycle training and certification level I within 12 months of hire.
Experience - Three years experience in a medical setting.
Advanced knowledge of CPT4, ICD9/10, HCPCS, and modifiers. Knowledge of medical terminology.
Experience with medical billing, including working with insurance companies, third party administrators, and collections with heavy emphasis on customer phone contact.
Experience working in a medical setting
Experience in scheduling and/or registration
Experience working with an electronic medical record system