Patient Account Representative II in Savannah, Georgia at St. Josephs Candler
St. Josephs Candler
Savannah, Georgia, 31405, United States
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Job Description
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Position Summary
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The Patient Account Representative II must ensure that claims are compliant with federal and state regulations. Responsibilities include but are not limited to billing, prompt follow-up and understanding of the laws which govern billing regulations. Escalates claims and follows up with payer provider representatives for account resolution. Attends payer meetings. Responsible for learning payer contracts to ensure appropriate payment has been made and correct adjustments have been taken. Assists with training new employees. Assists co-workers with questions regarding claim errors, rejections, and denials. Assists Team Leader, Supervisor, or Manager with adjustment approvals.
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Education
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High School Diploma - Preferred
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Experience
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3-5 Years Insurance Billing and Follow up with Hospital or Physician practice - Required
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2-3 Years Customer Service Experience - Preferred
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License & Certification
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Professional Certification - Preferred
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CPAR, CRCR, or CPFSS - Preferred
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Core Job Functions
- Resolves payer denials promptly and appropriately. Writes appeal letters for denied claims. Mails paper claims promptly to the proper address. Re-bills accounts when necessary.
- Submits assigned claims through Meditech and Billing Clearinghouse and provides confirmation reports to the manager. Reviews the Accounts Receivable Aging Report and works outstanding claims, oldest to newest, making calls to appropriate payer to determine claim status. Works with payer on resolving claim disputes, submits requested paperwork, and notifies Appeals Group for all denials.
- Seeks answers/assistance from the appropriate source. Keeps up to date on billing/compliance rule changes. Attends payer meetings and training provided by payers. Assists with training new staff.
- Assists with training new staff. Responsible for learning payer contracts to ensure appropriate payment is received and appropriate adjustments are taken. Assists Manager and Supervisor with adjustment approvals. Assists with special projects as assigned
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Job Location
Savannah, Georgia, 31405, United States
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