What are the responsibilities and job description for the Patient Accounts Representative position at Boston Childrens Hospital?
Job Summary
Patient Accounts Representative will:
Coverage/Referral/Authorization
To qualify you must have:
Boston Children’s Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.
Patient Accounts Representative will:
Coverage/Referral/Authorization
- Collect, verify, and record all demographic information required for financial pre-processing of patients.
- Verify insurance eligibility utilizing available technologies, payer websites, or by phone contact with third party payers
- Ensure that correct insurance company name, address, plan, and filing order are recorded in the patient accounting system
- Utilize payer exception reports to update coverage / PCP information
- Contact clinical departments and PCP offices to secure referrals and enter into patient accounting system
- Document all actions taken on account with clear and concise account notes
- Participate in process improvement opportunities
- Prepare and submit accurate insurance claims to payer within proper timeframes. Accept, reject, and reconcile claim runs daily. Ensure prompt resolution of outstanding insurance claims.
- Effectively work payer scrubber and denial reports daily
- Review claims for accuracy and correct errors as needed
- Collaborate with referral/authorization staff to resolve issues
- Update demographic and coverage information as needed
- Resolve claims processing issues with 3rd party payers and provide all requested
- information timely; engage patients and family members to resolve claim or insurance issues when needed
- Provide documentation to have claims processed and paid. Research, prepare, and provide 3rd party payer appeals. Request account adjustments in accordance with payer contractual agreements
- Document all actions taken on account with clear and concise account notes and maintain billing logs as required
- Prepare reports as required. Monitor and identify trends, denials/claim errors by payer and refer as appropriate
- Maintain a thorough understanding of 3rd party payer contracts.
To qualify you must have:
- A high school level of educational development
- Previous experience in a medical billing setting, preferably on an automated system is preferred
- Analytical skills to gather and interpret data in situations in which the information or problems are relatively routine
- Ability to exchange information on factual matters. Interaction requires courtesy and tact when dealing with patients, hospital employees and third parties
- Fluency in oral and written English, with emphasis on communication skills and the ability to document records. The ability to communicate effectively both orally and in writing and provide empathy in difficult interpersonal situations is required
- Ability to work with diverse internal and external constituencies
- Attention to detail, good organizational skills, ability to meet priorities within set timeframes, and ability to work as part of a team
Boston Children’s Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.
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