Position Summary

The Patient Accounts Billing Representative is responsible for review of unbilled claims and bills, assuring timely billing and claim resolution to expedite payment. Process all accounts in order to minimize billing time and maximize cash flow.

Completes the editing of claims in the HIS system. Completes the processing of claims either on paper or electronically to third party carriers. Completes follow-up on aged accounts as directed. Review trial balance reports and process late charges.

Essential Functions and Responsibilities Includes the Following:

1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors.

2. Insure adherence to federal and state billing regulations

3. Completes accurate billing for all third party insurance carriers.

4. Monitors host system and biller scrubber to insure timely resolution of unbilled accounts.

5. Completes review of third party trial balance reports within the current month.

6. Researches and initiates refunds to patients or insurance carriers as needed.

7. Sends inquiries to patients regarding inaccurate or incomplete information.

8. Completes charge adjustments and allowances entries on accounts as needed.

9. Recodes accounts by insurance carrier and plan number and enters into the HIS for re-billing purposes.

10. Processes rejections on third party accounts.

11. Review mail correspondence and respond accordingly.

12. Review online billing edits for errors, corrections or missing information. Enter the necessary corrections into HIS.

13. Assists with telephone calls as needed.

14. Completes rebilling process for late charges on a daily basis

15. Monitors host system and bill scrubber for billing delays and to expedite processing.

16. Performs all other related duties as assigned.

Education & Experience Requirements

High School Graduate required. Clerical experience. Required.

 Clerical and business aptitude with one to two years of hospital experience. The ability to use basic office equipment and knowledge of CTR computer terminals a plus. Medical terminology is helpful but not mandatory.

Core Competencies

The ability to cooperate with others. Must be able to speak, write, understand and communicate in the English language. Effectively communicate with internal and external customers. Integrity to handle the confidential aspects of work. Retains composure under stress

 

Salary Range:$53,851.20-$80,782.07