Patient Accounts Representative organizes inpatient and outpatient claims for electronic or hard copy mail and forwards to appropriate third party payers. Reviews claims to make sure that payer specific billing requirements are met, follows-up on billing, determines and applies appropriate adjustments, answers inquiries, and updates accounts as necessary. Being a Patient Accounts Representative requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Patient Accounts Representative works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Patient Accounts Representative typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
At KidsPeace, the Patient Account Specialist is responsible for accurate and timely billing of all services delivered as well as ensuring all revenue is collected.
Qualifications (Education, Trainings and Experience):
High School Diploma or equivalent required. BA/BS degree in related field with equivalent work experience preferred.
Minimum 1 years’ experience in billing/collections/cash application in a healthcare setting preferred.
Basic skill with the Microsoft Office suite (Outlook, Word, Excel, etc.) is required.
Strong mathematical, analytic skills and attention to detail preferred.
Ability to work in a fast-paced environment with changing/competing priorities. Able to prioritize tasks and stay organized.
Experience with third party payers, Medicaid, Managed Care and governmental billing/collections preferred.
Must be at least 21 years of age.
Valid driver's license required.
Job Duties:
Ensure accurate and timely billing of claims to payers.
Verify all services delivered are billed to the correct payer.
Work all pre-billing/post-billing reports to ensure correct data on claims.
Identify and resolve claim issues.
Guarantee timely secondary billing submissions based on the payer requirements.
Complete understanding of contract requirements of each payer as it relates to billing/collections (timely filing, specific invoicing requirements, etc.)
Ensure timely processing of any re-billing invoices/claims. Manage any fiscal year-end billing.
Follow up & troubleshoot outstanding Accounts Receivable balances.
Run reports including (but not limited to) claim aging, held claims, unbilled claims.
Work with the program and funding sources to correct any issues/re-bill claims.
Follow up with funding sources on a regular basis to obtain status of payment on claims.
Ongoing active collection engagement to minimize risk of any negative write-offs or adjustments to the AR.
Develop and maintain program specific billing & collection process documentation.
Work closely with various KidsPeace departments (finance, contracts, programs, etc.) to resolve any issues with payment.
Facilitate resolution of discrepancies caused by payer that resulted in short/over/no pays.
Conduct accounts receivable revenue cycle meetings with interdisciplinary teams on a regular basis to identify troubled accounts and payer trends.
Propose solutions for reimbursement on difficult accounts.
Collaborate on process improvement on the full revenue cycle process.
Responsible to complete special A/R projects when rates increase/decrease retroactively.
Other special projects as assigned.
KidsPeace is the employer of choice in the mental and behavioral healthcare field. As a KidsPeace associate, you can expect the following:
· Competitive compensation structures and the opportunity for associates to gather valuable practical experience and advance careers much more quickly than at other providers.
· Generous paid time off that we actively encourage our associates to use which promotes a work/life balance.
· Tuition assistance and a student loan forgiveness program to ensure that when you work to improve your ability to help our clients, you can rely on KidsPeace to support you.
· Comprehensive benefits package including life and disability insurance as well as pet insurance!
· An organizational culture filled with respect and the comradery of like-minded colleagues who live the mission to Give Hope, Help and Healing to Children, Adults and Those Who Love Them.
KidsPeace is proud to be an Equal Opportunity Employer supporting workforce diversity.
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Job Type: Full-time
Pay: $15.00 - $18.00 per hour
Expected hours: 40 per week
Benefits:
Schedule:
Work Location: In person
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