Billing/Patient Accounts Rep (Remote) - Beacon Health System : Job Details

Reports to Patient Accounts Manager. Performs a variety of duties related to the billing of patient accounts. Submits appropriate claim forms, electronic billing, maintaining the insurance file master, payment posting, and daily balancing.MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, inspire health, and connect with heart.
• VALUES: Trust. Respect. Integrity. Compassion.
• SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Audit Process

• Reviews patient accounts data including demographic patient/guarantor information, insurance information, and appropriateness of charges.
• Communicates identified problems to appropriate supervisory personnel and participates in appropriate corrective action.
• Ensures all appropriate documentation, including but not limited to, updated addresses, account notes, etc. has been entered into the Patient Accounting system for future reference.

Billing/Electronic Claims

• Enters correct patient account data to impact the production of an accurate and appropriate UB-04 or CMS1500 claim form.
• Ensures proper conformance with established government and third-party processing standards by working all edit errors to ensure clean claims are submitted to payers.
• Corrects any errors in charging and/or insurance data to facilitate submission of a clean claim.
• Submits and/or mails accurate and complete UB04 or CMS1500 claim forms to patients/guarantors and various government and third-party payors in a timely manner.
• Demonstrates ability to submit primary governmental and commercial claims electronically daily. Ensure that status of claims and the billing secondary claims are submitted in an accurate manner.

Follow-up

• Completes prompt follow-up of outstanding governmental receivables and takes appropriate action to ensure timely reimbursement.
• Audits paylist weekly to ensure denied claims, due to inaccurate information, have been corrected and rebilled in a timely manner.
• Works with patients and/or family member to ensure timely payments.
• Keeps abreast of changes in policies, procedures, regulations and requirements of the governmental payor.
• Request, prepares and submits necessary documents required for payment including but not limited to prior authorizations, consent forms and letter of non-coverage.

Communications

• Demonstrates good interpersonal skills by communicating with customers, patients, physicians, co-workers and other departments in a friendly, caring, sincere and cooperative manner.
• Communicates with internal and external departments or agencies in order to provide or obtain information to resolve outstanding governmental patient receivables.
• Contribute to the overall effectiveness of the department
• Completes other job-related duties and projects as assigned.

ORGANIZATIONAL RESPONSIBILITIESAssociate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:

• Leverage innovation everywhere.
• Cultivate human talent.
• Embrace performance improvement.
• Build greatness through accountability.
• Use information to improve and advance.
• Communicate clearly and continuously.

Education and Experience

• The knowledge, skills, and abilities as indicated below are normally acquired through the successful completion of a High School Diploma or Equivalent. No previous experience is required.

Knowledge & Skills

• Demonstrated technical knowledge of the UB04 and CMS1500 claim form and its use and application for government billings.
• Demonstrated technical knowledge of government agency policies, procedures, regulations and requirements.
• Organizational skills necessary to manage and control automated and manual billings and follow-up.

Working Conditions

• Prolonged exposure to computer terminals.

Physical Demands

• Occasional lifting of storage boxes weighing up to 50 pounds when filled with completed forms.