Craven County, NC
Patient Relations Representative IV
Craven County, NC, New Bern, North Carolina, United States, 28560
Salary:
$40,071.00 Annually Location :
New Bern, NC Job Type:
Full-Time Job Number:
10775 Department:
Health Division:
Health Administration Opening Date:
07/01/2025 Closing Date:
Continuous FLSA:
Non-Exempt
Primary Purpose
Primary purpose of this position is to validate patient account information via the patient encounter form and various clinical records to ensure correct billing for services rendered and post to A/R ledger. Essential Functions
Responsible for posting daily charges from eSuperbill or encounter forms by 5:00pm. Responsible for verifying completeness of all information such as charge codes, diagnosis and modifiers, provided by clinical staff at the time of charge entry to ensure accuracy, timely payments, and to maximize revenue. Determines correct method of resolving discrepancies by tasking and following up with appropriate staff to obtain complete information. Review patient demographic information at the time of charge entry to ensure accuracy and to provide feedback to the other front office staff regarding patient registration. Review insurance details, family household income, current charges and/or outstanding balances and verify dates of services.
Review all claims for accuracy prior to submission.
Schedule follow-up appointments Ensure all encounter forms are received by the Billing Office for charge entry. Demonstrate an understanding for patient confidentiality to protect the patient and the organization. Follow policies and procedures that contribute to the efficiency of the billing office. Keeps supervisor informed of matters regarding charge entry. Respond to inquiries from the clinical staff, social workers, and clerical staff regarding billing and coding information of the patient. Provide income verification and insurance documentation to clinical staff, as requested, to support referrals and/or orders. Collect and post payments from, both current and outstanding, patient debt to individual accounts. Payment plans are setup for accounts not paid in full. Other methods may be through the normal billing process or by utilizing the County's NC Debt Set-Off program currently in place. Notify our in-house Debt Set-Off coordinator of 60-day delinquent accounts for submission to the IRS. Keep informed of updated fee scales as published by the Health Department and other agencies, along with private provider updates for filing of claims. This is important so that the Health Department can achieve the maximum collection. Verifies encounters received against the daily schedule and tracks missing encounters as well as encounters returned to the clinic for missing information. Balance daily deposits to the cash drawer via the day sheet. A deposit slip is prepared and turned in to the accounting section by the Accounting Tech III.
Contact insurance companies for unpaid claims and patient verification. Ensure all prepayments are applied to charges by 5:00pm. Review and update pending insurances for eligibility. If eligibility cannot be determined, services older than 60 days are considered to have no coverage and then transferred to the patient's responsibility. Responsible for mailing Company Billing invoices monthly by the first of every month
Turning on television in the lobby by 8:00am and off by 5:00pm Provide backup to other Patient Relations Representatives positions within the unit. Required to construct letters as the need arises. The Administrative Officer will review all correspondence before documents are released outside of the agency. Correspondence pertains to letters to other agencies, insurance carriers, and health department patients. All documentation should be proofread for spelling, punctuation and grammar. Other duties as assigned by supervisor(s) and/or management. In the event of a disaster, may be required to assist as needed.
Minimum Education and Experience
Graduation from high school and demonstrated possession of knowledge, skills and abilities gained through at least two years of office assistant/secretarial experience; or an equivalent combination of training and experience. Knowledge, Skills, and Abilities
Requires a comprehensive understanding of accounts receivable management in a healthcare setting. Strong customer service, organizational and communication skills are essential to this position. Strong working knowledge of CPT, ICD-10, HCPCS, modifiers, coding and documentation guidelines. Also requires general computer skills, typing skills and a working knowledge of Medicaid and Medicare Compliance, OSHA and HIPAA. Craven County offers regular full-time employees a wide variety of employee benefits including:
Health Insurance Health Insurance is provided by ACS Benefits Services and covers a wide variety of healthcare services. Craven County pays 100% of Employee Only premium cost. Employees have the option to add child and spouse dependent coverage at their own cost.
Dental Insurance Dental Insurance is provided through the Delta Dental PPO and Delta Dental Premier network administered by ACS Benefits Services. It covers a percentage of basic to major dental procedures, including orthodontia for children. Craven County pays 100% of Employee Only premium cost. Employees have the option to add child and spouse dependent coverage at their own expense.
Life Insurance and AD&D Craven County provides eligible employees with $10,000 life insurance and accidental dealth and dismemberment coverage through OneAmerica AUL. Employees have the option to purchase additional coverage and/or dependent coverage at their own expense.
Disability Insurance Craven County provides eligible employees with $50.00 per week in disability insurance through OneAmerica AUL. Employees have the option to purchase additional disability insurance at their own cost.
North Carolina Local Governmental Employees' Retirement System Eligible employees are automatically enrolled in the retirement system and must contribute 6% of their gross salary each pay period. Once eligibility requirements are met, employees will be able to receive monthly payments for life based on their salary, age, and years of service credit.
NC401k Craven County contributes 2% of eligible employees' gross salary into the 401(k) account regardless of the employee's deferral amount. In addition, the County matches employee deferrals up to an additional 3%.
Annual Leave Regular full-time employees earn annual leave based upon years of service. Eligible employees begin to accrue annual leave as soon as they start but must complete a six month probationary period before they are eligible to use annual leave.
Less than two years of service earns 10 days per year. Two but less than five years of service earns 12 days per year. Five but less than 10 years of service earns 15 days per year. 10 but less than 20 years of service earns 18 days per year. 20 or more years of service earns 20 days per year. Sick Leave Regular full-time employees earn 3.69 hours of sick leave per pay period. Craven County accepts eligible sick leave from the State of North Carolina, any of its political subdivisions, any local government entity or authority, or municipality in North Carolina.
Paid Holidays County employees receive 11-14 paid holidays annually. The Board of County Commissioners may adjust the holiday schedule as deemed necessary.
Longevity Eligible employees earn $200 in longevity after five years of service by October 31 of the qualifying year. Longevity benefits increase $25 per year up to a maximum of $1,000.
Merit Program Craven County offers a merit program. Up to 56% of eligible employees may receive a performance-based merit increase each year.
Supplemental Benefits County employees are also offered a variety of supplemental benefits to select at their own expense such as Life Insurance, Vision Insurance, Flexible Spending Accounts, Critical Care policies, Cancer policies, Long-term Care policies, Hospitalization policies, 457b Deferred Compensation Plan and Aflac.
Employee benefits are subject to change or may be contingent upon funding availability.
$40,071.00 Annually Location :
New Bern, NC Job Type:
Full-Time Job Number:
10775 Department:
Health Division:
Health Administration Opening Date:
07/01/2025 Closing Date:
Continuous FLSA:
Non-Exempt
Primary Purpose
Primary purpose of this position is to validate patient account information via the patient encounter form and various clinical records to ensure correct billing for services rendered and post to A/R ledger. Essential Functions
Responsible for posting daily charges from eSuperbill or encounter forms by 5:00pm. Responsible for verifying completeness of all information such as charge codes, diagnosis and modifiers, provided by clinical staff at the time of charge entry to ensure accuracy, timely payments, and to maximize revenue. Determines correct method of resolving discrepancies by tasking and following up with appropriate staff to obtain complete information. Review patient demographic information at the time of charge entry to ensure accuracy and to provide feedback to the other front office staff regarding patient registration. Review insurance details, family household income, current charges and/or outstanding balances and verify dates of services.
Review all claims for accuracy prior to submission.
Schedule follow-up appointments Ensure all encounter forms are received by the Billing Office for charge entry. Demonstrate an understanding for patient confidentiality to protect the patient and the organization. Follow policies and procedures that contribute to the efficiency of the billing office. Keeps supervisor informed of matters regarding charge entry. Respond to inquiries from the clinical staff, social workers, and clerical staff regarding billing and coding information of the patient. Provide income verification and insurance documentation to clinical staff, as requested, to support referrals and/or orders. Collect and post payments from, both current and outstanding, patient debt to individual accounts. Payment plans are setup for accounts not paid in full. Other methods may be through the normal billing process or by utilizing the County's NC Debt Set-Off program currently in place. Notify our in-house Debt Set-Off coordinator of 60-day delinquent accounts for submission to the IRS. Keep informed of updated fee scales as published by the Health Department and other agencies, along with private provider updates for filing of claims. This is important so that the Health Department can achieve the maximum collection. Verifies encounters received against the daily schedule and tracks missing encounters as well as encounters returned to the clinic for missing information. Balance daily deposits to the cash drawer via the day sheet. A deposit slip is prepared and turned in to the accounting section by the Accounting Tech III.
Contact insurance companies for unpaid claims and patient verification. Ensure all prepayments are applied to charges by 5:00pm. Review and update pending insurances for eligibility. If eligibility cannot be determined, services older than 60 days are considered to have no coverage and then transferred to the patient's responsibility. Responsible for mailing Company Billing invoices monthly by the first of every month
Turning on television in the lobby by 8:00am and off by 5:00pm Provide backup to other Patient Relations Representatives positions within the unit. Required to construct letters as the need arises. The Administrative Officer will review all correspondence before documents are released outside of the agency. Correspondence pertains to letters to other agencies, insurance carriers, and health department patients. All documentation should be proofread for spelling, punctuation and grammar. Other duties as assigned by supervisor(s) and/or management. In the event of a disaster, may be required to assist as needed.
Minimum Education and Experience
Graduation from high school and demonstrated possession of knowledge, skills and abilities gained through at least two years of office assistant/secretarial experience; or an equivalent combination of training and experience. Knowledge, Skills, and Abilities
Requires a comprehensive understanding of accounts receivable management in a healthcare setting. Strong customer service, organizational and communication skills are essential to this position. Strong working knowledge of CPT, ICD-10, HCPCS, modifiers, coding and documentation guidelines. Also requires general computer skills, typing skills and a working knowledge of Medicaid and Medicare Compliance, OSHA and HIPAA. Craven County offers regular full-time employees a wide variety of employee benefits including:
Health Insurance Health Insurance is provided by ACS Benefits Services and covers a wide variety of healthcare services. Craven County pays 100% of Employee Only premium cost. Employees have the option to add child and spouse dependent coverage at their own cost.
Dental Insurance Dental Insurance is provided through the Delta Dental PPO and Delta Dental Premier network administered by ACS Benefits Services. It covers a percentage of basic to major dental procedures, including orthodontia for children. Craven County pays 100% of Employee Only premium cost. Employees have the option to add child and spouse dependent coverage at their own expense.
Life Insurance and AD&D Craven County provides eligible employees with $10,000 life insurance and accidental dealth and dismemberment coverage through OneAmerica AUL. Employees have the option to purchase additional coverage and/or dependent coverage at their own expense.
Disability Insurance Craven County provides eligible employees with $50.00 per week in disability insurance through OneAmerica AUL. Employees have the option to purchase additional disability insurance at their own cost.
North Carolina Local Governmental Employees' Retirement System Eligible employees are automatically enrolled in the retirement system and must contribute 6% of their gross salary each pay period. Once eligibility requirements are met, employees will be able to receive monthly payments for life based on their salary, age, and years of service credit.
NC401k Craven County contributes 2% of eligible employees' gross salary into the 401(k) account regardless of the employee's deferral amount. In addition, the County matches employee deferrals up to an additional 3%.
Annual Leave Regular full-time employees earn annual leave based upon years of service. Eligible employees begin to accrue annual leave as soon as they start but must complete a six month probationary period before they are eligible to use annual leave.
Less than two years of service earns 10 days per year. Two but less than five years of service earns 12 days per year. Five but less than 10 years of service earns 15 days per year. 10 but less than 20 years of service earns 18 days per year. 20 or more years of service earns 20 days per year. Sick Leave Regular full-time employees earn 3.69 hours of sick leave per pay period. Craven County accepts eligible sick leave from the State of North Carolina, any of its political subdivisions, any local government entity or authority, or municipality in North Carolina.
Paid Holidays County employees receive 11-14 paid holidays annually. The Board of County Commissioners may adjust the holiday schedule as deemed necessary.
Longevity Eligible employees earn $200 in longevity after five years of service by October 31 of the qualifying year. Longevity benefits increase $25 per year up to a maximum of $1,000.
Merit Program Craven County offers a merit program. Up to 56% of eligible employees may receive a performance-based merit increase each year.
Supplemental Benefits County employees are also offered a variety of supplemental benefits to select at their own expense such as Life Insurance, Vision Insurance, Flexible Spending Accounts, Critical Care policies, Cancer policies, Long-term Care policies, Hospitalization policies, 457b Deferred Compensation Plan and Aflac.
Employee benefits are subject to change or may be contingent upon funding availability.