Patient Account Representative | Claims, Denials & Appeals

General information

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Job Title Patient Account Representative | Claims, Denials & Appeals Functional Area Teammate - Revenue Cycle City Remote Work Location Type Remote Employment Type Full-time (30+ hrs/week)/FULLTIME

Description & Requirements

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Position Description & Requirements

PRACTICE OVERVIEW

Radiology Partners, through its owned and affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, we advance our bold mission by innovating across clinical value, technology, service and economics, while elevating the role of radiology and radiologists in healthcare. Radiology is a team sport, and Radiology Partners is building a community of physicians and support teammates who embody our practice values and believe in our bold mission to transform radiology. Our support team is a vital force within the practice, using their gifts and talents to improve the overall healthcare experience. Using a proven healthcare services model, Radiology Partners provides consistent, high-quality care to patients, while delivering enhanced value to the hospitals, clinics, imaging centers and referring physicians we serve.

POSITION SUMMARY

Radiology Partners is seeking a Patient Account Representative who will focus on reviewing remittance advice forms to verify proper reimbursement to make adjustments and prepare/submit appeals as required. Verifying that records for patients include all information required for proper reimbursement. Teammate will be responsible for handling billing and collections, denials, appeals, checking claim status, and following up with insurance payors.

POSITION DUTIES AND RESPONSIBILITIES

• Responsible for all aspects of account follow up and collections, including processing appeals
• Reviews explanation of benefits (EOBs) to ensure proper reimbursement of claims and reports any problems, issues, or payer trends
• Ability to analyze accounts and determine next appropriate action for account resolution
• Ability to identify, resolve and escalate trends to ensure timely payment
• Collaborates with management to reduce aging of accounts by providing verbal and written communication
• Works with payers to determine reasons for denials, corrects and reprocesses claims for reimbursement in a timely manner
• Accurately and thoroughly documents the pertinent collection activities in appropriate system
• Maintains HIPPA patient confidentiality standards for medical and financial information

DESIRED PROFESSIONAL SKILLS AND EXPERIENCE

• High school or GED preferred
•  3+ years physician billing and collections experience highly preferred
•  In depth knowledge of Medicare, Medicaid, comme