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Schedule/Status:Monday - Friday; 8:00am-4:30pm; Full Time

Standard Hours/Week:

40

General Description:The position shall exemplify the desired Culture of Choice® and philosophies of Parrish Healthcare. The Patient Account Representative is responsible for following up directly with commercial and governmental payers to resolve billing issues and secure appropriate reimbursement in a timely manner. This individual identifies and analyzes denials and payment variances and enacts corrective measures as needed to effectively communicate and resolve payer errors.

Key Responsibilities:

Maintains an understanding of claims management, third-party payer guidelines, state and federal regulations, and all other functions of the job.

Maintains Communicates directly with payers to follow up on outstanding claims, resolve payment variances, and achieve timely reimbursement.

Ensure accounts are paid accurately based on governmental reimbursement methodology or managed care contracts by examining denied or underpaid claims to determine reasons for discrepancies. Adjusts, appeals or refunds accounts accordingly

Updates and maintains accurate files on each payer, including contact names, addresses, phone numbers, and other pertinent information; thoroughly documents all interactions with payers or activities completed in the account notes.

Reviews and takes action on documentation from all payer sources that relates to the collections of A/R.

Monitors accounts and makes recommendations to move to self-pay.

Assists patients in resolving insurance issues.

Effectively handles all patient and insurance correspondence and phone calls in a timely manner.

Ensure accounts are paid accurately based on governmental reimbursement methodology or managed care contracts. Adjusts, appeals or refunds accounts accordingly.

Works daily, weekly and monthly reports for various account corrections including insurance updates, late charge billing, zero pays, claim rejections, adjustment corrections, etc.

Recognizes and communicates any trends to Supervisor for process improvement or escalation to payor reps.

Understands customer service duties and covers as needed.

Performs similar or related duties as assigned.

Knows fire, disaster and safety procedures and regulations as it pertains to the work area

Requirements:

Formal Education:

High School Diploma or GED required.

Work Experience:

Minimum of one (1) year experience, accounts receivable experience required. One to three years of relevant experience in medical collections or billing preferred.