Patient Account Representative

Company: Universal Health Services, Inc.
Location: Kirkland
Posted on: March 17, 2023

Job Description:

Responsibilities

Quality healthcare is our passion, improving lives is our reward. Join us as we work to change lives and transform the delivery of healthcare. The Patient Account Representative is responsible for the effective and creative use of proven billing follow-up techniques, and self-directed initiative, to bill and collect payments and resolve outstanding account balances. The Account Rep's responsibility includes the oversight and management of outstanding accounts receivable assigned to them in an organized and efficient manner to maximize collections and achieve the hospital's financial and Business Office performance objectives. The Patient Account Representative is responsible for developing and maintaining a thorough, current knowledge of industry standards and payer requirements. This includes the responsibility to develop an understanding of hospital-based services and to ensure that these services are properly reflected on claims billed to payers and the subsequent payments received from those payers. Wage Range:Minimum: $24.00/hourMaximum: $33.91/hour
Qualifications

• High school graduate
• A minimum of two years' experience in insurance billing and/or healthcare collections
• Working knowledge of managed care and business software programs (Excel) JOB DUTIES AND STANDARDS OF PERFORMANCE
  Maintain accurate knowledge of billing requirements of all insurances to ensure that each bill is submitted in an accurate and timely manner to ensure prompt payment. This includes

  Ensure that all Medicaid authorizations and eligibility are in effect before billing Medicaid clams; adhere to the Provider One billing guidelines to ensure timely payment of claims.Utilize MS-4 editor and Emdeon/WayStar editor to ensure that electronic claims are submitted accurately.Keep thorough documentation of billing instructions for specific carriers, levels of service, and special situations so that billing errors can be avoided.Work the Payments and Adjustments Report to ensure that payments are posting accurately and adjustments are submitted in a timely manner.Document all billing issues and actions in MS4 and enter the appropriate message codes in a timely manner.Follow up on outstanding claims effectively to collect payment and resolve accounts.

  Initiate contact with payers regarding outstanding claims within 15 days of billing to ensure that the claim has been received and is in process; status obtained from a payer website is appropriate at this stage of the follow up process.After determining that the claim has been received by the payer, consistent follow up must occur every 2 weeks until the claim is paid. If the claim is not paid according to the website, call the payer for status (Medicaid is an exception; RA status is appropriate follow up).Follow up in a creative fashion to remove obstacles to payment and contribute to the resolution of accounts. If a claim is denied by Medicare or Medicaid thoroughly research the reason for denial and make sure your resubmission is correct.Respond to correspondence from payers and patients in a timely manner. If rebilling is required the action must occur within 48 hours.Payment delays or other issues which could potentially result in failure to meet cash collection goals, along with suggestions for resolution will be communicated to the Business Office Director on a daily basis.Account Reps are expected to work an average of 30 accounts per day. The follow up must advance the account through the revenue cycle toward payment.Document all account follow up activities in MS4 and enter an action code that is appropriate; as additional information becomes known enter the corrections in MS4 and inform others appropriately.Utilize available systems and account follow-up tools effectively and organize the work day in an effective and efficient manner to prevent delays and to maximize productive account contacts.Reconcile the account and take appropriate action after payment is received.

  Document the Explanation of Benefits (EOB) on MS4 in an "EOB Note"Reconcile the account in regard to the EOB, checking that the claim was paid according to the correct contracted rate, the patient portion is correct according to the insurance benefits quoted, and the contractual allowance was posted correctly.Bill the patient's secondary insurance or the patient if appropriate and change the financial class.Follow up with the carrier if any unexpected days were denied. If there is no documentation of a denial in Midas, enter the denial in Midas and inform the BOD and UR so that the appeal process can be initiated. Communicate all denials or unpaid days to the BOD so that the account can be accrued accurately.Payments which result in credits will be reviewed; refunds or appropriate adjustments will be processed and submitted to the BOD for approval.If an account is deemed uncollectible or has been approved for charity, Administrative Adjustment, or finally denied, initiate the electronic request form, via the Bad Debt Portal so it can be approved and written off in a timely manner.Maintain accounts and files in a neat and organized manner to facilitate their use by other individuals as needed.Perform other related duties as required.Write up cash on the specified days.

  Sort mail and distribute correspondence to coworkers as needed.Provide back up for other Business Office positions as needed.ADDITIONAL STANDARDS OF PERFORMANCE

  Utilize the principles of service excellence in all work situations.

  Treat everyone as a guest.Demonstrate professionalism and excellence in the things I do.Practice teamwork.Be dependable and reliable.

  Report to work as scheduled and comply with the attendance policy.Follow facility policy for use and reporting of planned leave.Follow work assignments/instructions as indicated and utilize work time and resources in an efficient, economical manner.Attend in-service training as required and seek learning opportunities.Participate as a positive, professional team member.Comply with the facility dress code.JOB FACTORS:

  Knowledge of facility and corporate policies and procedures.Skill in organizing and prioritizing workloads to meet deadlines.Skill in telephone etiquette.Effective oral and written communication skills.Must have excellent interpersonal communication skills to effectively communicate ideas/problems/instructions (oral or written) with employees, peers, and Leadership both onsite and at the corporate level.Ability to communicate effectively with patients and co-workers.Ability to adhere to safety policies and procedures.Ability to use good judgment and to maintain confidentiality of information in accordance with HIPAA Laws.Ability to work as a team player.Ability to demonstrate tact, resourcefulness, patience and dedication.Ability to accept direction and adhere to policies and procedures.Ability to recognize the importance of adapting to the various patient age groups (adolescent and adult).Ability to analyze situations, evaluate data, recommend/implement courses of action that would improve the functioning of systems/processes he/she is involved in.Ability to interpret, adapt and apply guidelines and procedures.Ability to work in a fast-paced environment.Ability to meet corporate deadlines.Ability to react calmly and effectively in emergency situations.PHYSICAL, MENTAL, AND SPECIAL DEMANDS

  Ability to work at least a 40-hour week.Ability to sit for long periods (8 to 10 hours).Ability to use both hands in fine manipulation of small tools (copier, computer, telephone, calculator, facsimile machine).Ability to push and pull up to 10 lbs. (file cabinet drawers, computer paper boxes).Ability to see well enough to read handwritten and typewritten material.Ability to lift and carry up to 25 lbs. to move/transfer file boxes, and data processing paper.Ability to stoop, kneel, and bend to retrieve files from bottom shelves and drawers, to move boxes of paper and forms to computer printer.Ability to reach, turn, and twist above and below the waist.Ability to stand and walk the facility grounds.Ability to spend 10% of working time outside in temperatures varying from below 0 F. to 110F.Ability to spend 90% working time in environment of continuous low voices and office machine noise typical for business office atmosphere.Ability to handle a variety of repetitive tasks at a moderate level.Ability to occasionally handle electrical, mechanical, or equipment emergenciesBENEFITS:

  • Insurance:
    • Full time and part time employees (scheduled 20 or more hours per week) and their families are eligible to be covered by medical, dental, vision, and basic life insurance
    • Retirement Plans:
      • Employees are able to enroll in the Company's 401(k) plan or deferred compensation plan
      • Paid Time Off/Vacation:
        • Full-time Employees are eligible for 21 days of PTO annually. Part-time employees are eligible for also eligible for PTO depending on FTE.
        • Extended Leave Bank sick hours accrue at a rate of 1.85 hour per pay period for Full-time employees, and is prorated according to hours worked for part-time employees
        • Holiday hours are included in the PTO accruals
        • Additional Benefits Information:
          • www.benefits.uhsguest.com

Keywords: Universal Health Services, Inc., Kirkland , Patient Account Representative, Other , Kirkland, Washington