Patient Acct Rep Level III - Remote

Patient Acct Rep Level III - 100% Remote

Fully Remote
• PFS Billing
- Memphis, TN 38103

Position Type Full Time Job Shift Day Education Level High School/GED Travel Percentage None Category Financial Services

Responsible for providing coverage for all Level I and Level II functions in the PFS unit to ensure a consistent staffing complement. This position will also ensure the accurate and timely processing of patient accounts related to billing, collections and reimbursement service for Regional One Health in accordance with PFS standards, policies and procedures assigned to Level II Employees, as well as cash posting, mail handling, scanning, sorting, document assembly, coping, faxing and data entry assigned to the Level I employees.

Demonstrates a level of accountability to ensure data and codes are not changed on claims prior to submission. Gathers all information necessary to process patient claims. Ensures that daily productivity standards, billing and re-billing files are met to obtain the required completion rate. Conducts training for new hires and provides monthly refresher courses for existing hires.

Key Job Responsibilities

Performs billing, collections and reimbursement services. Ensures that all required financial/demographic information is secured. Provides monitoring, follow-up, and research of all assigned patient accounts as required to maintain accurate records pertaining to patient and/or account information. Provides courteous and professional customer service at all times.

Ensures that PFS standard and requirement of 100% is met and that all payments are retrieved and posted on the date received. Gathers all information necessary to process claim payments and ensures that all clinical data codes associated with claim payment are not changed prior to claim payment. Researches submitted cash payments by verifying patient account numbers and appropriate facility. Enters all cash receipts and credit card payments to correct accounts and reconciles to batch.

Monitors and performs cash reconciliation to identify cash posting errors. Reconciles cash payments to daily bank lockbox and EFT deposits.

Reviews erroneous claims and researches Commercial guidelines to ensure corrections, adjustments, and proper modifications to claims in accordance with documented billing procedures. Responds to patient and insurance company complaints, correspondence, inquiries and requests for information by analyzing charges and bill and contracted arrangements, determining billing errors Contacts clinical departments and HIM to obtain information to determine claim integrity and works with department to resolve claims.

Provides continuous updates and information to PFS management regarding ongoing errors, payer related issues, registration issues and other controllable related activities affecting reimbursement and payment methodology.

Maintains an active working knowledge of all Governmental Mandated Regulations as it pertains to claims submission. Ensures successful implementation of Governmental Regulatory Billing changes, including but not limited to Medicare OPPS effective August 1, 2000. Performs the necessary research in order to determine proper governmental requirements prior to claims submission. Collects balance owed from third party payers in accordance with state and federal laws governing collection practices.

Maintains an active working knowledge of all billing and reimbursement requirements by Payer. Continuously receives updates and information regarding challenges and newly revised billing and reimbursement practices to ensure compliance.

Ensures daily productivity standards are met and daily billing and re-bill files are cleared in accordance with documented…