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Patient Account Rep II - OP
Collects and follows up on all accounts assigned prior to, during, or after admission and discharge. Serves as patient advocate during the cycle of the account. Responsible for accurate posting of insurance company and patient payments, including accurate contractual adjustments and denials. Maintains and is familiar with UB and HCFA Billing Manuals. Independently assesses Claim Edit, Transaction Editing System, Clearinghouse, or other applicable billing edit messages to resolve any issues preventing release of physician or hospital claims from Emory's systems. With increasing self-sufficiency, provide thorough customer service, including robust knowledge of specialty billing practices (e.g. explain anesthesia billing to patients inquiring about medical direction modifiers by rote). Must demonstrate a working knowledge of CPT, ICD-10, modifiers, coding and documentation guidelines.
MINIMUM QUALIFICATION: High school diploma or equivalent. Two (2) years of collections, billing, and/or registration experience in a healthcare or insurance setting OR any combination of equivalent education and experience. Certified Patient Accounts Representative (CPAR) and/or Certified Patient Financial Counselor (CPFC) preferred for positions in the hospital setting. Typing skills with a minimum of 35 wpm and good communication skills. PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
