Escalation Rep (Ft) Patient Accounting

Huntsville Hospital Madison , AL 35758

Posted 3 months ago

Overview

  • Reviews and audits accounts located in contract management system on a daily basis to resolve and maintain collection status on an account prior to escalating to Team Lead for further review.

  • Reviews and processes commercial accounts through contract management system.

  • Verifies eligibility, corrects and resubmits claim, and files third party insurances as necessary by adding/updating insurance information to Host system..

  • Utilizes contract and denial management system and responds to requests from insurance carrier for additional information necessary to process claims.

  • Analyzes expected reimbursement information in contract management system.

  • Utilizes contract management system/contract foundation to ensure the accounts are properly paid. Reviews EOB's and determines accurate account balance, detailed denial description, and applicable appeal process.

  • Identifies and corrects transactions, such as invalid insurance information, incorrect charges, and posting errors, in Host system. Posts adjustments in HQ system.

  • Reviews and verifies claim export data in electronic billing system, contract management, and/or host system.

  • Out of Network

  • No Pre-Certification/Lack of Authorization/Notification

  • Experimental/Investigational

Qualifications

  • General application knowledge of EXCEL, WORD, and ACCESS.

  • Proven applicable experience working in an environment that utilizes electronic billing, internal report archives, and tools for applicable database management strongly preferred.

  • 3 years + working experience of Hospital or Physician office billing and collection processes including producing account appeals with positive outcomes strongly preferred.

  • Prefer at least 1 year of supervisory experience strongly preferred.

  • Proven applicable experience of preparing complex correspondence to resolve accounts strongly preferred.

  • Effective communication skills verbally and written with internal Hospital departments, Physician Offices, Patient, and Insurance payors.

  • Must be able to effectively manage a large volume of accounts while maintaining a high accuracy and positive outcomes.

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