Patient Account Rep TRH

Responsible for daily billing, follow-up, reviewing and working edits to ensure the highest reimbursement on claims. Job Duties: Collects, reviews, updates and ensures systems and/or documentation for complete and accurate billing. Follow up on claims status, investigates and resolves obstacles to prompt reimbursement. Completes data entry as needed for claim submission, client invoicing and/or patient invoices. Identifies and reports any payer trends, denial patterns and delays to management. Adheres to state, federal and HIPAA laws and guidelines with regard to patient records and collections. Contacts patients/insurance companies to collect unpaid insurance claims. Stays informed about changes in Medicare and Medicaid. Demonstrates the ability to be flexible, organized and function well in stressful situations. Interacts with patients/families in a professional manner. Provides explanations regarding statements, insurance coverage. Treats patients/families with respect; ensures confidentiality of patient records. Maintains a good working relationship within the department and with other departments. Maintains a professional working relationship with insurance companies. Performs other duties as assigned. Ensures documentation meets current standards and policies. Creates and works appeals and/or reconsiderations for insurance claims resolutions. Follows up on insurance claims by calling or online processes to ensure payment. Education: Requires a high school diploma or GED. Training/Experience: Thorough understanding of Medicare, Medicaid, HMOs, PPOs private insurance companies. Ability to work in a fast-paced environment with shifting priorities and rapid changes. Ability to communicate with internal and external customers in a professional manner. Ability to multi-task, establish and meet deadlines, set and achieve high performance standards. Ability to identify and mitigate issues, make sound judgments and decisions. Basic knowledge of revenue cycle best practices. Ability to work independently and within teams as needed. Moderate knowledge of Microsoft Windows and Office applications. Skills/Qualifications: Knowledgeable of HIPAA compliance. EMR/EHR Experience. Customer Service. Time Management. Organization. Attention to Detail. Professionalism. Quality Focus.

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