Account Representative - Professional Billing

The individual in this role independently performs professional administrative duties related to billing, collection, customer service, accounts payable, and accounting. Listed below are some of the job duties the qualified applicant will be expected to completed, if hired into this position.

Principal Duties and Responsibilities:

• Responsible for a variety of tasks in the department. May input data, monitor and run reports, process checks, balance information, verify information, file, sort, and send bills.
• Submit claims to payers assuring claims meet the clean claim definition to assure timely and accurate payment.
• Contact insurance companies to obtain preauthorization (in some departments), resolve outstanding balances, incorrect payments, claim denials or information needed to adjudicate claims. Work with clinical areas to resolve rejections and determine collectability or need for adjustment. Process payment/claim resolution documents, making determinations on balances based on contractual arrangements and insurance coverage.
• Apply insurance and patient payments to accounts, monitoring for compliance with contractual agreements to assure appropriate reimbursement for services provided. Prepare and balance bank deposits.
• Answer patient questions regarding balances, make referrals to other areas as appropriate, i.e. clinical area, Patient Rights, etc. Create and maintain customer-friendly environment with internal and external customers.
• Establish payment arrangements within established guidelines.
• Review accounts to determine patient delinquency and initiate collection steps or refer to collection agency. Coordinate accounts and balances with collection agency.
• Responsible for the monitoring and careful use of resources impacting them in a moderate capacity (i.e. Balance cash drawer, cut checks, effective use of time).
• Maintain knowledge of payer regulations, contracts and billing requirements and act as a resource to clinical sites regarding these requirements.
• May attend staff meetings
• May support and promote a recovery focused environment and person-centered approach within the program.
• Must maintain annual training and demonstrate competency in the required programmatic training.
• Performs other duties or functions as assigned.