Patient Account Representative (claims specialist)

Overview

This is a local position for Reading, PA, however, it is hybrid. 

Responsibilities

Call and status outstanding claims with third party payors.

· Review claims issues and make corrections as needed and rebill.

· Utilize claims clearing house to review and correct claims. Resubmit electronically when available.

· Review explanation of benefits to ascertain that claim processed and paid correctly.

· Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.

· Manage daily productivity via patient accounting system and productivity reports. Needs to maintain an average of 30-40 accounts worked per day minimum.

· Prorate patient accounts and monitor that balance due is in the correct financial class.

· Report an overview of the week to the BOD and participate in AR meetings.

· Gather and interpret data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.

· Assist financial counselors as needed.

· Alert Financial Counselors and Business Office Director of all benefit eligibility matters that suggest or challenge reimbursement.

 

TOWBH

Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

· High school diploma or equivalent required.

· Three or more years’ prior admissions and or collections experience in a hospital setting required.

· Psychiatric experience preferred.

LICENSES/DESIGNATIONS/CERTIFICATIONS:

· Not applicable

 

 

 

 

 

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