Patient Account Rep- Collector Job at LCMC Health
POSITION SUMMARY:
The Patient Accounting Representative in the Central Business Office primary responsibility is to collect patient claims. The PAR is responsible for all aspects of follow-up activity which result in the timely resolution of accounts. Knowledge of Commercial, Managed Care, Medicare, and Medicaid insurance preferred. Accurately documents all collection activity within the system of record.
JOB SPECIFICATIONS:
Education:
Minimum Required:
High school diploma or equivalent
or two (2) years of relevant experience
Preferred: N/A
Experience:
Minimum Required:
One (1) year of Epic Hospital Billing or equivalent hospital patient accounting software experience
Preferred:
Two (2) years of experience in a healthcare setting, particularly in hospital billing, collections, payment processing, or denial management
License/Certification:
Minimum Required: N/A
Preferred: N/A
Special Skills/Training:
Minimum Required:
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Must have basic computer skills
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Working knowledge of system reports and the ability to analyze system information to determine the impact of possible changes
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Hospital and professional billing processes and reimbursement
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Third-party contracting
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Insurance protocols, delay tactics, systems, and workflows
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ERISA guidelines for denials and appeals
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Regulations related to denials and appeals
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Experience with Epic, or equivalent EMR software
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Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change
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Possesses efficient time-management skills and proven ability to multitask under tight deadlines
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Demonstrates excellent customer service skills
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Effective writing and communication skills
Reporting Relationships:
Does this position formally supervise employees? No
JOB STANDARDS:
Account Follow Up
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Research accounts using EPIC and internet resources that are made available.
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Follows up on claim submission and remittance review for insurance collections.
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Takes appropriate account activity on uncollected account balances by contacting insurance payers and/or patients via phone, e-mail, or online to bring the account to resolution timely.
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Resolves issues and creates resolution that will bring in revenue eliminating re-work.
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Updates plan IDs, patient, or payor demographic/insurance information.
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Submits additional information like medical records, itemized bills, and other needed documentation requested from payors.
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Reviews reimbursement to identify billing or coding issues preventing full payment and request re-bills, secondary billing, or corrected bills as needed.
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Recognizes and escalates potential payment delays, issues, and trends with aged accounts to Supervisor.
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Participates in and attends meetings, training seminars, and in-services to develop job knowledge.
Quality and Productivity
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Maintains inventory to remain current without backlog while achieving productivity and quality standards.
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Maintains responsibility for accurate and timely completion of daily follow-up or denial account assignments.
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Maintains Quality by effectively and accurately documenting all activity on the patient account
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Displays efficient time-management skills.
Compliance
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Maintains knowledge of current payer guidelines and reimbursement policies while demonstrating comprehension of the techniques, policies, and procedures necessary to perform position responsibilities.
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Acts in accordance with LCMC’s mission and values while serving as a role model for ethical behavior.
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Observes best practice processes in billing, follow-up, and customer service activities.
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Adheres to federal and state regulations related to the protection of patient information (e.g., the Health Insurance Portability and Accountability Act (HIPAA) as well as facility-specific guidelines.
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Participates in staff training that aligns with recognized improvement opportunities and increases understanding of Medicare, Medicaid, and all third-party payor requirements as well as general revenue cycle processes.
Adaptability and Professionalism
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Demonstrates the ability to make sound and timely decisions by reasonably evaluating information and taking appropriate actions.
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Willing to flex work assignments.
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Supportive of the department and LCMC goals and values.
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Receptive to constructive criticism.
The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and should not be considered a detailed description of all the work requirements that may be inherent to the position.
LCMC is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, disability status, protected veteran status, or any other characteristic protected by law.
Location: LCMC Health · CBO-Pt Financial Services
Schedule: Full-time, Days, 8-4:30
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