Medicare Follow-up Rep (Patient Account Rep) at Portland, OR (Downtown) – Portland, Oregon

Third-Party Follow-Up and Collection

• Analyze and follow-up on Medicare accounts on AEOS worklist and take appropriate action(s) to resolve all account balances. STANDARD: 250 action items (average, depends on staffing)
• Supply needed information to Medicare that will expedite processing of payments, i.e., resubmit claims, correct Return to Provider claims, prepare appeals, communicate with various third parties and our patients.
• Process financial allowances, contract allowances and other adjustments as appropriate.
• Access various systems to check claim status and eligibility. Systems may be online or require phone contact. Responsible for maintaining a high level of security and confidentiality in the use of these systems.
• Update account insurance coverage as appropriate.
• Calculate outpatient MSP claim reimbursement and determine if billing is necessary.

Customer Service

• Receive phone calls from Customer Service and other Patient Business Services sections. Analyze account activity to provide explanations and resolve customer concerns. Update account information as needed.
• Review inappropriate charges, determine which accounts should be escalated to supervisor’s attention, and take necessary steps to resolve customer concerns.

Other Duties as Applied

• Recent Microsoft Office applications experience in Windows environment (within the last 2 years)
• Recent online payer experience (within the last 3 years)
• Current Medicare program knowledge (within the last 3 years)

Job Related Knowledge, Skills and Abilities (Competencies):

• Familiarity with medical terminology
• Typing 55 WPM
• Ability to use multiple system applications
• Strong written and oral communication
• Legible handwriting
• Detail oriented, analytical
• Ability to interpret regulations
• Punctual, good attendance, positive attitude
• Ability to work in high volume, production environment
• Excellent customer service skills
• Knowledge of CPT, HCPCS, ICD-10 coding
• Strong self-directed work ethic and ability to exercise independent judgement