Patient Account Representative III Pro Fee; Onsite, Hybrid, Remote

Position: Patient Account Representative III Pro Fee (Onsite, Hybrid, Remote)
At North Bay Health, the Patient Account Representative III Ambulatory is responsible for the timely and accurate billing, follow-up and collection of ambulatory patient accounts. Each account representative is responsible for the processing of accounts for all services and specialties offered within the North Bay Ambulatory practices through the use of standard and North Bay prescribed billing practices and regulatory requirements.

PRIMARY JOB DUTIES

* Follow up responsibility on accounts with practices, carriers and/or patients account becomes zero balances through a combination of payment and adjustments per North Bay guidelines and contracts.

* Managing account population to ensure AR aging is meeting or exceeding set goals.

* Timely processing for billing all initial claims including those edited through the billing scrubber.

* Timely processing of carrier denials to ensure maximum cash benefit.

* Other duties as assigned which include assisting with back logs as they arise.

* Other duties as assigned which may include periodic reassignment of account workload to address specific areas.

* Customer Service. Continually present a tactful, pleasant, and professional manner both verbal and in writing. Handle conflict situations diplomatically and achieve resolution. Understand the intent of the message and be able to communicate clearly, all to provide an exceptional experience, each time. Respond to all inquiries whether verbal or written in a prompt and timely fashion.

At North Bay Health, our vision is to be the trusted healthcare partner of choice for the communities we serve. We are dedicated to improving the well-being of our community by providing accessible, high-quality care to all who need it. Every member of our team plays a vital role in delivering compassionate and effective healthcare solutions. We invite you to join us in our mission to ensure that every patient and family member feels valued, respected, and cared for throughout their healthcare journey.

Education:

* High school graduate or equivalent preferred.

* College courses with emphasis on Business preferred.

Experience:

* Three to five years of recent professional fee billing and collections experience, preferably in a multi-specialty practice environment required.

* Familiarity with use of CPT4, HCPCS and ICD-10 coding.

* Proficiency in Medicare, Medi-Cal and Commercial insurance plans, both HMO and PPO.

* Experience with UB-04 and/or HCFA 1500 claim forms billing.

* Experience in account follow up resolution for both electronic and manual claims.

* Demonstrated ability to effectively investigate, analyze and problem solve.

* Demonstrated service and success in teamwork and consistent high productivity and quality.

Skills:

* Ability to quickly master computer programs related to claims processing.

* Ability to understand the terms of payor contracts and fee schedules.

* Ability to understand Knox-Keene regulations as well as demonstrate an understanding of managed care concepts and terminology.

* Ability to effectively prioritize work, as well as the ability to process accounts quickly to meet deadlines.

* Ability to process claims accurately and timely.

* Ability to exercise appropriate, independent judgment and effectively solve problems.

* Knowledge of medical terminology.

* Ability to perform several different types of tasks each day and to adapt to changing priorities.

* Knowledge of personal computers with an emphasis on public folders, shared drives, Internet, and downloading and sorting spreadsheets and word processing programs required.

Interpersonal

Skills:

* Demonstrates the True North values. The True North values are a set of value-based behaviors that are to be consistently demonstrated and role modeled by all employees that work at North Bay Health. The True North values principles consist of Nurture/Care, Own It, Respect Relationships, Build Trust and Hardwire Excellence. Ability to communicate effectively and pleasantly to members, providers, payors and internal staff is essential.

A willingness to work as a team player with co-workers and other internal staff, as well as people outside North Bay.

Hours of Work:

* 8 hours per day.

* Consistent attendance and work at the agreed upon hours of work is required.

Compensation:

* Hourly Salary Range Min. $32.15 - $37.18 per hour (offered hourly rate based on years of experience)

Work Location Requirement:

* This position may be performed onsite or remotely; however, onsite work is preferred based on business needs.

* Preference will be given to qualified candidates who are able to work onsite and are located within a reasonable commuting distance.

Remote Work Eligibility:

* This position is open to candidates located within the continental United States. Due to state-specific employment requirements and workers' compensation regulations, we are unable to support remote work arrangements in the following locations:
Washington, Ohio, Wyoming, North Dakota, Puerto Rico, and the U.S. Virgin Islands.