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Patient Account Representative

Company: Health Quest
Location: Danbury
Posted on: May 5, 2021

Job Description:

Overview Nuvance Health is a family of award-winning nonprofit hospitals and healthcare professionals in the Hudson Valley and western Connecticut. Nuvance Health combines highly skilled physicians, state-of-the-art facilities and technology, and compassionate caregivers dedicated to providing quality care across a variety of clinical areas, including Cardiovascular, Neurosciences, Oncology, Orthopedics, and Primary Care. Nuvance Health has a network of convenient hospital and outpatient locations - Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations. For more information about Nuvance Health, visit www.nuvancehealth.org. Responsibilities TITLE: Patient Account Representative - Charge Entry/PaymentsDEPARTMENT: Practice Management REPORTS TO: Billing Supervisor- Chare Entry/Payments LOCATION: The Summit in Danbury, CT (2 days onsite, 3 days remote) RESPONSIBILITIES AND STANDARDS: This position incorporates the rolls of registration and charge entry, claim submission, payment posting, and payment discrepancy. Responsibility I * Enter new patient demographics and update existing patient demographics according to department policy. Find missing information using internal and online resources--- Verify insurance benefits and eligibility for all charges according to department policy--- Accurately registers patients in billing system including insurance and referrals/authorizations --- Contact hospital and/or physician's office as needed to obtain all necessary billing information in a timely manner--- Review charges prior to entry for missing and/or incomplete information, including performing coding accuracy review according to department policy--- Notifies providers of charges which require coding corrections, providing coding information and regulations to aid the provider--- Maintain log of surgical procedures waiting for surgeons coding information--- Reports to Supervisor if charges are not received from providers--- Reviews all claims for accuracy prior to submission to clearinghouse--- Thoroughly researches account issues prior to presenting to Lead Rep or Supervisor--- On a daily basis reviews the electronic data interchange vendor website for payer claim rejections. Determines reason for rejection and identifies claim form locators causing the errors. Corrects information submitted internally causing the rejection and resubmits claim--- Maintains knowledge of payers claim submission requirements--- Reviews all claims for accuracy prior to submission to clearinghouse--- Tracks all claim batches to ensure all claims are accounted for--- Accurately assigns claims to front offices for correction--- Assigns and removes claims from pending credentialing status as appropriate--- Prints batched paper claims according to department policy--- Ensures that all charges are paid accurately and within the required time parameters by identifying and taking the required steps to investigate and resolve payment denials and other payment issues. --- Reviews patient Explanations of Benefits (EOB) including; approved amount, amount paid, denial codes, other information provided by insurance carrier related to payment or denial of benefits to determine if further investigation necessary i.e. if claim was denied, incorrectly paid accounts--- Has a full understanding of all payor contracts as related to reimbursement, remaining current with any changes--- Process all returned checks from bank--- Transfer credits between Tax ID's within billing system; provide totals to Lead Account Rep--- Verify, reconcile and prepare the daily front office deposits in an accurate and timely manner--- Update the daily spreadsheet with all the financial information --- Accurately enters all denial codes as noted on EOBs--- Post bad debt vendor transactions into billing system including adjustment, commission and payment according to department policy--- Completes corporate health insurance spreadsheet according to department policy--- Communicates with insurance company in a timely manner to address contractual payment errors--- Review electronic remittance advice posting (where applicable) for proper application to system records --- Posts all ERA and payments received in the mail on a daily basis reconciling at the end of the day. --- Works all errors on ERA reports according to department policy, including assigning accounts for additional research as needed--- Thoroughly researches account issues prior to presenting to Lead Rep or Supervisor Responsibility II * Ability to integrate coding and reimbursement rule changes into daily work in a timely manner --- Demonstrates knowledge of medical terminology, CPT, ICD9, and HCPCS coding--- Maintain compliance with local, state, or federal guidelines as it relates to job function--- Maintains a current knowledge of the billing and reporting program(s) as well as websites--- Consistently meets goals and objectives related to accuracy and productivity--- Accepts additional tasks to meet the needs of the department --- Passes all assigned work related courses within the timeframe allowedResponsibility III--- Maintains professional demeanor at all times with patients, co-workers, providers, and management--- Handles stressful situations effectively, displaying a calm demeanor--- Identifies personal and professional areas for improvement and actively seeks out ways to meet personal development needs--- Accepts and integrates constructive criticism into daily work--- Arrives at valid conclusions and decisions independently--- Meets deadlines and time frames for assigned projects and tasks--- Participates effectively in meetings; provides related and appropriate input and is properly prepared--- Promote a positive cooperative team approach with excellent patient interaction and customer service--- Questions the status quo and takes initiative with the manager's knowledge, where appropriate--- Reports all trends and issues to Supervisor/Manager in a timely manner--- Requires minimum supervision to accomplish assigned tasks. Seeks guidance and direction as appropriate--- Responds effectively to change, new directions and priorities--- Shares solutions to common problems and technical issues with co-workers Qualifications and Experience: * Minimum 3 years medical billing coding experience and/or follow-up experience --- Strong working knowledge of CPT and ICD9 coding principles. --- Good written and verbal communication skills. --- Computer literate--- Basic knowledge of financial transactions--- Knowledge of Managed Care, Medicare and Medicaid billing regulations and guidelines--- High School degree of equivalent Physical and Mental Factors:Physical: Requires light physical effort on a regular basis, as in frequent standing, walking, bending, stooping or reaching. Mental: High volume of work and strict deadlines impose moderate stress. Qualifications Qualification and Experience: * Minimum 3 years medical billing coding experience and/or follow-up experience --- Strong working knowledge of CPT and ICD9 coding principles. --- Good written and verbal communication skills. --- Computer literate--- Basic knowledge of financial transactions--- Knowledge of Managed Care, Medicare and Medicaid billing regulations and guidelines--- High School degree of equivalent Physical and Mental Factors:Physical: Requires light physical effort on a regular basis, as in frequent standing, walking, bending, stooping or reaching. Mental: High volume of work and strict deadlines impose moderate stress.

Keywords: Health Quest, Danbury , Patient Account Representative, Other , Danbury, Connecticut

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