The Brigham and Woman's Physician Organization (BWPO) has the need for a Sr. Patient Accounts Representative reporting to the Sr. Billing Manager/or Patient Account Manager. Activities and duties of the Sr. Patient Account Representative involve the follow up of outstanding patient invoices, interacting with insurance companies on appeal of inappropriately denied/or paid services, and response to patient inquiries (both written and verbal) regarding their bills.
Responsible for daily management of accounts receivable process and follow up in the Billing System (Epic), including daily screening and correcting of claims for accuracy.
Review, correction and completion of edit queues weekly for the particular insurance (s) assigned.
Follow-up on pending claims, this includes following up with the insurance company, document the findings and gather and send the necessary documentation to process the claims.
Responsible for the appeals process. This also includes gathering the information necessary to process the appeal accurately. Such as finding researching payer websites, identifying the correct diagnoses and/or procedure code, pulling of documentation such as EOB's, requesting medical records, reviewing registration/eligibility and benefits, as well as documenting all work performed on the patient invoice.
Customer Service calls. Responsible for handling customer service calls and demonstrate excellent customer service skills, listening, problem solving, professionalism, etc
Management, follow up and resolution of credit balances and adjustments within assigned accounts receivable.
Handle confidential information with accordance with HIPPA standards.
All other duties assigned.
High School diploma or equivalent required.
A Minimum of 1 year experience in a healthcare preferred.
Excellent organizational skills
Once fully trained have a complete understanding of the entire appeals process from start to finish
Strong Interpersonal skills, service orientation and team work
Knowledge of Physician third party billing and collections preferred
Thorough knowledge of third party reimbursements preferred
Basic proficiency in Microsoft Word and Excel