PATIENT ACCOUNT REPRESENTATIVE - Insurance Follow-Up Team

Location
Chesapeake, VA
Posted
Feb 23, 2017
Closes
Mar 24, 2017
Function
Nurse
Industry
Healthcare
Hours
Full Time
Job Description:
Sentara Healthcare is seeking an organized, customer focused and self-directing Patient Account Representative with excellent communication, complex problem solving, mathematical skill and service orientation to follow-up on insurance claims at our Battlefield corporate office in Chesapeake, VA.

As a member of our Commercial Department Follow-Up team, the ideal candidate will have a minimum of 2yrs experience in a medical, hospital, clerical, accounting or customer service setting or an equivalent combination of education, training and experience with knowledge of:

•Insurance Explanation of Benefits and remittance advice
•Insurance Reimbursement and contractual adjustments
•Microsoft Applications, including Word, Excel.

The selected candidate for this position will:

• Use RWS to work the assigned portfolio of patient accounts from multiple insurance carriers that require review for possible billing issues. Accounts are worked promptly and accurately while adhering to HIPAA guidelines.
• Research and resolve a variety of issues related to the payment of the claim which may require a phone call to the patient, insurance company or the use of insurance company websites.
• Monitor contractual compliance of insurance payers and third party payers and organize supporting information in order to communicate discrepancies to management.
• Confirm that claims are processed and paid in a timely manner and resolve issues pertaining to payment posting such as missing payments or overpayments.
• Divide the correspondence received and handout to the teammates when assigned. The correspondence received is worked daily.
• Assist staff and patients with insurance and billing inquiries. Working e-mails.
• Responsible for effectively utilizing available resources including but not limited to HBOC, Epic, HIQA, and multiple insurance/claim verification websites during the performance of daily activities.
• Refund letters worked timely, obtaining correct insurance information and rebilling while refunding insurance that paid.
• Other duties and special projects as assigned.

Hours are: Monday - Friday 8:00am- 4:30pm, may be required to work overtime or on the weekend.

The employee is responsible for the following in assigned areas: billing for medium and low dollar claims, daily reconciliation, registration, auditing, and collection of information. Responds to phone inquiries and follows up to obtain information requested.

Education Level
High School Grad or Equivalent

Experience
Required: None, unless noted in the “Other” section below

Preferred: Billing - 1 year

License
None, unless noted in the “Other” section below

Skills
Required: Communication, Complex Problem Solving, Mathematics, Microsoft Excel, Microsoft Word, Reading Comprehension, Service Orientation

Preferred: None, unless noted in the “Other” section below