Patient Account Representative Iii

JOB DESCRIPTION: This position requires a comprehensive understanding of accounts receivable management in a healthcare setting. Effectively resolves complex or aged inventory with minimal or no assistance necessary. Manages and maintains email and phone message inventory, complete reports, and resolve high priority and aged inventory. Reviews all accounts assigned for collection prior to, during, or after admission and discharge. Performs progressive collection steps to discuss and clear balances on multiple accounts. Bills third party payors, when appropriate, by hard copy or electronic submission. Performs special billing tasks such as combined and split bills as needed. Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites and filing appeals. Independently assesses Claim Edit, Transaction Editing System, Clearinghouse, or other applicable billing edit messages to resolve any issues preventing release of physician or hospital claims from Emory's systems. Responsible for all facets of refunds and credit balance resolution including direct phone calls to Patients, Insurance Companies, and other departments as necessary in order to resolve credit balances. With minimal support from a supervisor, handle all aspects of insurance verification. Maintain knowledge of insurance rules, referral requirements, payor websites, eligibility portals, and Emory's verification systems. Under minimal supervision, responsible for reviewing scheduled elective accounts to ensure that certification has been obtained.
MINIMUM QUALIFICATIONS: High School Diploma or equivalent preferred and three (3) years of healthcare related experience OR any combination of equivalent education and experience. Knowledge of Medicare, Medicaid, and other contract payers (HMO, PPO) preferred. CPAR (Certified Patient Account Representative) preferred. Typing skills with a minimum of 35 wpm and good communication skills.
PHYSICAL REQUIREMENTS (Medium Max 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.