[Hiring] Patient Account Representative II REMOTE USA

­­­­Position: Patient Account Representative II

Date posted: 2025-05-04

Industry: other

Employment type: Full Time

Experience: 2 to 3 year               

Qualification: Bachelor’s Degree holder

Location: Brentwood, TN, United States, REMOTE

Company: ScionHealth

Description:

Hiring Patient Account Representative II (Remote)

Brentwood, TN

Description

POSITION SUMMARY

Responsible for timely accurate billing, and payment of third-party claims. The Representative is responsible for reporting exceptions, weekly reports of unbilled accounts, and for a complete working knowledge of coverage and types of insurance with which the Representative works.

PRIMARY DUTIES:

• Prepares appropriate claims for insurance companies, including specific supporting documentation, forms and authorization.
• Processes insurance payments and bills second insurance carrier if applicable. Investigates questionable insurance payments and follows up with patient and/or payor until claim is resolved. Prepares adjustment write-off for non-covered charges.
• Work with clinic office staff to resolve claim denials, investigate pre-authorizations, or obtain other necessary documentation.
• As necessary, researches credit balances and processes refunds to insurance companies for overpaid accounts.
• Obtains required insurance information from patients. Monitors the status of accounts pending requested information, completes follow up with the patient or insurance carrier until the claim is paid.
• Completes follow up each month according to accounts listed on the aging selection file report.
• Reviews correspondence, manual revisions, newsletters and payor websites to keep abreast of changes in insurance, Welfare, and Medicare coverage provisions and billing requirements.
• Receives and responds to inquiries from patients, insurance companies, Medicare, Medicaid and other third parties regarding patient accounts.
• Reviews itemized statements and insurance billing forms produced in-house to insure quality and accuracy. Claims that require proration, non-covered, or claim fixes are given to the Supervisor to fix.
• Prepares, files and records accurate medical liens for accident claims that may be covered by automobile insurance or a homeowners policy. Completes and files amendments and releases as necessary.
• Reviews daily payment report to assure proper application of insurance payments.
• Investigates third party liability claims; follows up for proper billing information and payment. Works with attorneys or their representatives to resolve claims.
• Responsible for proper handling and logging of medical records according to HIPAA and Medical Center Policy.
• Reviews weekly patient balance report to insure proper mailing of self-payment statements.
• Demonstrates a commitment to the key values of Service to the Poor, Reverence, Integrity, Wisdom, Creativity and Dedication.
• Working with various vendors on reconciliation of the file placements.
• First point of contact for all vendors. Responsible for maintaining issue logs and working all accounts assigned. Can include updating insurance, rebills, adjustments, refunds, close and return accounts.
• The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified, and shall not be considered as a detailed description of all the work requirements that may be inherent in the position. Performs other related duties as assigned.

Qualifications

LICENSE, EDUCATION & EXPERIENCE

Required:

• High School Diploma or equivalent
• Ability to detect and correct billing errors, knowledge of ICD and CPT/HCPCS coding systems, skill in mathematical computations.
• Analytical skills, a high degree of accuracy and attention to detail.
• Problem-solving skills and the ability to adapt to changing procedures are necessary
• Strong written, verbal and interpersonal skills.
• Must be able to organize work efficiently and document billing procedures.
• Must be competent in the use of a personal computer and spreadsheet and word processing software, fax machine, scanner and copier.

Preferred:

• Medical Secretary or Associate degree.
• Job related experience in medical billing and/or insurance claims processing
• Knowledge of Medicare, Medicaid and insurance coverage and billing regulations.