Patient Accounts Rep Central Billing Office Full-Time Days (Limited-Duration)

Employment Type:Full timeShift:Day ShiftDescription:At Saint Alphonsus Health System, we are looking for people who are living out their calling. We want you to be passionate about coming to work, and challenged to achieve your potential. Living by these virtues, we pride ourselves on exceptional service and the highest quality of care.This is a Limited Duration position, with an approximate end date of December, 2020. This date is subject to change and may be extended, dependent on business need. The successful candidate will be considered a full-time colleague and eligible for benefits accordingly.We are looking to hire a Patient Account Rep in Meridian! This position will be located at our Central Billing office located off of the Eagle Exit.As a Patient Account Rep at Saint Alphonsus Health System, you will be responsible for efficiently processing claims and payments to ensure an accurate and timely revenue cycle. Core responsibilities include reviewing claims for complete information, correcting and completing forms as needed, accessing information and translating data into information acceptable to the claims processing system, and preparing claims for return to provider/subscriber if additional information in needed. Additional follow-up responsibilities include maintaining all appropriate claims files and following up on suspended claims; and assisting, identifying, researching and resolving coordination of benefits, subrogation, and general inquiry issues, then communicating the results by accurately documenting in the appropriate software systems. Creates a positive experience for the patient and family members by addressing their billing related questions.Our ideal candidate can work in a team environment. This candidate will also have excellent verbal and written communication skills, as well as great customer service attitude. This customer service attitude will transfer over to polite and professional phone etiquette. This candidate will need to be detail orientated and have the ability to complete tasks in a timely manner.General Requirements:

Three years of experience in a medical office billing setting preferred.

Understanding of various medical claims formats.

Working knowledge in medical terminology, CPT and ICD-10 coding.

Knowledge of payer contracts and reimbursement.

Basic knowledge of billing regulations for payers.

Problem identification and problem solving skills.

Willingness to participate and attend off site meetings/seminars.

Proficiency in computer skills which include Word, Excel, typing skills and 10-key.

Must be able to multitask and remain calm with multiple interruptions and demands.

Comprehensive understanding of clinic medical billing information and related systems.

Comprehensive knowledge of applicable Federal, State, and local laws and regulations related to HIPPA and payers.

Education:

High School Diploma or equivalent required.

Essential Functions:

Submits third party and patient claims (electronically or by hard copy), including the correction of errors in an effort to provide timely, accurate billing services. Edits HCFA-1500 (and where appropriate UB) claim forms within the patient accounting system, using proper data element instructions for each payer, applying principles of coordination of benefits, and ensuring that correct ICD-10 diagnosis, HCPCS and CPT procedure codes are utilized and communicates any charge entry errors to the appropriate resource for resolution. Ensures that claims are in accordance with regulations set forth by the state and federal governments, third party payers, and SAMG guidelines.

Performs all billing and follow-up functions, including the investigation of over-payments, underpayments, payment delays resulting from denied, rejected and/or pending claims, with the objective of appropriately maximizing reimbursement based upon services delivered and ensuring that the claim is paid/settled in the most timely manner. These functions will be in coordination with and depending on threshold metrics defined by the Key Performance Indicators.

Utilizes available data and resources to make decisions regarding complexity of claim processing and payment propensity, and the appropriateness of transferring account to Collection vendor(s) or other resources for follow-up;

Researches claim rejections, making corrections, taking corrective actions and/or referring claims to appropriate staff members for follow through to ensure timely claim resolutions;

Proactively follows-up on delayed payments by contacting patients and third party payers, and supplying additional data, as required;

May perform financial counseling activities, including but not limited to

Counseling patient/guarantor on patient’s financial liability, third party payer requirements and outside financial resources, including private organizations and foundations, eligibility vendor(s), Medicaid, Medicare, Champus, and/or federal disability programs, etc.;

Counseling patient/guarantor of payment plan options and establishes appropriate plan according to SAMG CBO's collections policies and procedures and

Investigating No Fault and Workers’ Compensation cases, retrieving police report and insurance information, as required.

Evaluates accounts, resubmits claims, and performs refunds, adjustments, write-offs and/or balance reversals, if charges were improperly billed or if payments were incorrect obtaining supervisor's approval when necessary; and

Updates and refiles claim forms in a timely, accurate manner proofing batch listings to batch totals.

Uses tasking worklog within patient accounting system to track follow up and research on claims to maintain timely processing of claims.

Responds to patient and third party payer inquiries (telephone, fax, mail and web-based patient portal), complaints or issues regarding patient billing and collections, either responding directly or referring the problem to an appropriate resource for resolution.

Communicates with physicians and their office staff, Medical Records/Health Information Management, Utilization Review/Case Management, Managed Care, Ancillary and Nursing staff, as required to clarify billing discrepancies, and obtain demographic, clinical, financial and insurance information.

Identifies and develops process improvements based on outcomes from denial reviews.

Analyzes various reports to research and obtain information that will lead to a more accurate processing of claims.

Demonstrates ability to create and maintain various accounts receivable reports within the patient accounting system.

Demonstrates ability to properly complete all logs used for communication and daily/monthly balancing.

Maintains an organized work environment and manages priorities.

Completes Special Projects as identified by management.

Saint Alphonsus and Trinity Health are committed to promoting diversity in its workforce and to providing an inclusive work environment where everyone is treated with fairness, dignity and respect. We are committed to recruit and retain a diverse staff reflective of the communities we serve. Saint Alphonsus and Trinity Health are equal opportunity employers and prohibit discrimination against any individual with regard to race, color, religion, gender, marital status, national origin, age, disability, sexual orientation, or any other characteristic protected by law.Trinity Health's Commitment to Diversity and InclusionTrinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities, and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually.Based in Livonia, Mich., and with annual operating revenues of $17.6 billion and assets of $24.7 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity Health employs about 133,000 colleagues, including 7,800 employed physicians and clinicians.Committed to those who are poor and underserved in its communities, Trinity Health is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services — ranked by number of visits — in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs. For more information, visit www.trinity-health.org at http://www.trinity-health.org/ . You can also follow @TrinityHealthMI on Twitter.