I. JOB SUMMARY/RESPONSIBILITIES:
• Follows-up on payment with insurance payers and patients on outstanding accounts.
• Expedites larger dollar accounts to ensure prompt payment. Monitors to ensure all insurance are billed in a timely manner.
• Identifies, posts and/or audits payments to ensure QMC has received correct/expected payment from payers in accordance with contract terms. Processes correspondence received from payers and patients.
• Responds to patient and insurance inquiries promptly and courteously.
II. TYPICAL PHYSICAL DEMANDS:
• Standing, sitting, walking, seeing, hearing, speaking, finger dexterity, repetitive arm/hand motions and gripping of an object.
III. TYPICAL WORKING CONDITIONS:
• Not substantially subjected to adverse environmental conditions.
IV. MINIMUM QUALIFICATIONS:
A. EDUCATION/CERTIFICATION AND LICENSURE:
• High School diploma or equivalent.
B. EXPERIENCE:
• One (1) year recent experience as Patient Accounts Representative, preferably in an acute care facility, demonstrating knowledge of Medicaid, Medicare, Third Party payer requirements, SNF/ICF, ICD-9 and DRG’s. An associate’s or bachelor’s degree in business administration, finance, accounting or healthcare related field and/or completion of a healthcare administration billing and coding program may be substituted for one (1) year experience as a patient accounts representative.
• Experience and/or background to demonstrate effective written and verbal communication skills in English.
• Experience with Windows applications, such as Word, Excel, etc., with demonstrated proficiency in using a mouse and keyboard.
• Experience to demonstrate knowledge of medical terminology.
• Experience with computer based applications, SMS and/or EPIC systems preferred.