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Full-time or part-time position

What is the expected salary for this Patient Services Representative - Catholic Health Services job?

Compensation will be discussed during the hiring process.

Patient Services Representative - Catholic Health Services job near me in Lauderdale Lakes, Florida, United States, Florida at Catholic Health Services | Jobs and Employment

Responsible for the billing and timely follow up of all assigned Insurance claims for Nursing Home and Hospital in a cost effective and efficient manner. Successful accounts receivable management is predicated on working closely with nursing home and hospital business office and admissions staff, as well as the various governmental regulatory agencies (i.e., DCF).

Knowledge & Experience Requirements

High school diploma and two years related experience of a combination of education and training.
Must be knowledgeable with computers, calculators, system applications, spreadsheets and other related office equipment.
Must have knowledge of computer office/clinical software
Must be able to read, write and understand the English language

Essential Functions

Billing of all Insurance claims via the Inovalon software (and when appropriate web portal or paper billing). This includes editing billing data and reconciling all bills via KNS.
Follow up and collections on all outstanding claims post discharge.
This includes the successful resolution of all claims in a timely and cost-effective manner.
Run all A/R aging reports after KNS month end to use as an A/R management tool.
Complete A/R spreadsheets and be prepared to review details with management at scheduled monthly review meetings.
On going management of detailed A/R trial balance for assigned payers to ensure proper timeliness of billing claims, appropriate documentation (i.e., authorizations, NOCA’s, etc.) are received and included on claims, appeals are submitted within appropriate timeframe. This includes overall compliance with all Payer and regulatory guidelines.
Follow up and facilitate resolution of all denied claims. Including identifying and communicating to Director root causes and trends resulting in denials (CBO; Facility; etc.)
Obtains Medical Records from appropriate facilities for the purpose of appealing denied claims.
Ensure that most recent NOCA’s are updated in the KNS database for Medicaid claims and maintained for future audits.
Maintain close working relationships with facility counterparts in business office, admissions office, case management office, medical records office, etc. to ensure effective revenue cycle management.
Utilization of all departmental system tools (i.e., KNS; Trace; SSI; etc.). In addition, identify and communicate any and all systemic issues that may result in payment delays, underpayments, lost revenue, etc.
Billing and follow-up for Medicare co-insurance billing to Medicaid and/or Medicaid MMC/MMA payers for SNF and all other lines of business (i.e., Hospital; Outpatient and Clinics).

Other Duties

All other duties assigned by the Supervisor, Revenue Cycle Manager and Vice President of Revenue Management.
Maintain your required license, certifications and mandatory skill updates.
Comply with all policies, local, state and federal laws and regulations.
Perform other duties as assigned.

Supervisory Responsibility

· No direct reports.

Physical Requirements

Must be able to lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds, walk, climb stairs or ladders, stand on feet for extended periods of time, etc.
Works in office environment with moderate to loud noise level.
Subject to frequent interruptions.
Work schedule may include working beyond typical schedule, including weekends and holidays.
Hand dexterity required for data entry on keyboard, requiring finger dexterity and eye-hand coordination.

Patient Services Representative - Catholic Health Services in Lauderdale Lakes, Florida, United States, Florida at Catholic Health Services

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