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Patient Account Representative II (3971)

Company: Nacogdoches County Hospital
Location: Nacogdoches
Posted on: June 12, 2021

Job Description:

High School Diploma or equivalent. Five (5) years experience in Hospital insurance collection background is preferred. Knowledge of insurance claims and reimbursement procedures, commercial, private and governmental insurance programs, CRT, business office machines, and printer.Skilled in timely follow-up of claims, proper telephone techniques, and good communication skills. Ability to work under pressure, solve problems and provide quick reaction or immediate response as required, and able to organize flow of work.Job SummaryPrepares all Hospital insurance claims following designated procedures established by each third party payer, i.e. commercial group, Blue Cross, Medicare, Medicaid, Workman's Compensation, Champus or private insurance. Responsible for systematic follow-up of insurance accounts from date insurance claims are billed to receipt of payments, conducts routine reviews to update patient's accounts to correct financial status. Serves as a source of assistance to patients who need help in preparing and submitting claims for personal reimbursement for accounts paid in full. Responsible for collection of personal portion of patient's charges for Hospital services in accordance with all State and Federal laws governing collection practices. Accurately posts cash transactions and maintains accurate Charge Master files. Correctly identifies and posts adjustments. Handles return checks in accordance with Hospital policy. Assists patients in the settlement of their account. Accurately researches accounts for credit balances prior to issuing a refund. Accurately maintains logs and reports as directed by the management.POSITION STANDARDS:Bill patient's third party claims.Must work at least fifty (50) claims per day.100% accuracy.Claims are mailed the same day they are received.Late charges are billed within forty-eight (48) hours of receipt.Answer incoming calls and correspondence concerning insurance billing and initiate calls and correspondence when additional information is required to bill patient's insurance.Responds to written inquiries within forty-eight (48) hours of receipt.100% effectiveness of telephone skills.Contact insurance companies and patients to secure payments.Make at least fifty (50) attempted contacts per day.Complete documentation to ensure timeliness of follow-up calls.Use of lawful, professional and effective follow-up techniques to secure prompt payment.Research and recommend appropriate adjustments for supervisor's approval.Compute accurately all accounts requiring a discount on a daily basis and prepare proper discount forms.Correspondence and re-billing.Correspondence worked on a daily basis.Re-bills should be referred to the billing department on a daily basis.Reclassify accounts after rejections are received or payment is not received after sixty (60) days.Promptness of reclassifying within twenty-four (24) hours of receipt.Promptness of reclassifying on sixty (60) day old accounts with non-payment.Files are to be filed accurately and within 24 hours of receipt 99% of the time.Returned checks.Redeposit check if possibleSend Certified Letter to maker.Notify Director of Patient Accounting of frequently returned checks.Assist patients in the settlement of their account.Records cash amounts received and portion charged to insurance or other third party.Prepares receipts and other related documents.Explains charges and answers other related inquiries from patients and their families regarding discharge procedures.Refers patients/families to other Hospital departments for assistance or information as required.Explains charges and answers other related inquiries from patients and their families regarding discharge procedures.Refers patients/families to other Hospital departments for assistance or information as required.Receives and processes accounts receivable checks and other mail received according to established procedures.Identifies appropriate Hospital accounts to ensure accurate application of payments received.Identifies appropriate transaction code to be used in posting patient accounts.Prepares and processes receipts.Prepares daily cash reports and balances all cash on hand.Investigates and resolves any out-of-balance problems.Consistently prepares refunds in an accurate manner, according to established procedures.Consistently monitors weekly credit balance report in a thorough manner to identify refunds to be processed.Bad debt log.Maintain every bad debt write-off report; pull every Medicare write-off to bad debt and post in separate worksheet.Monitor each Medicaid bad debt account and determine allowable write-off for Medicare cost report.Accumulate every Medicare/Medicaid account with crossover write-off and determine allowable amount to include in Medicare cost report.Accumulate every Medicare account write-off to Charity and determine allowable amount to include in Medicare cost report.Monitor Outstanding Self-pay and Specialty Accounts:Liens and LawsuitsEstatesBankruptcyMVA Lien, Lawsuits and Estates:Conduct or coordinate inpatient interviews.Research the event if needed.File liens.Communicate with patients including patient's family, attorney, insurance company, and law enforcement.Monitor claims for settlement, litigation, and legal action.Refer accounts for health insurance when appropriate.Provide and receive documentation from attorney's office.Pursue estatesWork all returned mail, insurance correspondence and miscellaneous correspondence daily.Consistently handles all inquires from patients, patient's families, insurance companies and co-workers in a timely, courteous, efficient manner.DEPARTMENTAL OR UNIT SPECIFIC:Handle any difficult situation or problem with the utmost caution.Consistently provides accurate information and timely, courteous assistance to other appropriate Hospital personnel regarding patient account charges and billing issues and related matters.Always responds to the Supervisor's request for information and assistance in a timely manner.Inspires confidence from co-workers, superiors, physicians' office staff and patients by performing and communicating in a highly professional manner at all times.Promote innovation within the department to increase productivity.Manage change so as to increase production and minimize disruptions.

Keywords: Nacogdoches County Hospital, Longview , Patient Account Representative II (3971), Other , Nacogdoches, Texas

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