Patient Account Coordinator
Type: Full-time
Pay Rate: $21.35 to $22.76 per hour
Essential Job Duties:
Conduct appropriate billing and collection activity directed toward insurance carriers and third party payers in a timely manner
Ensure consistent levels of cash flow for Warren General Hospital
Access demographic, financials, and insurance information to conduct collection activity on unpaid claims over 30 days
Reviews the daily claim forms for appropriateness of charges and coding; referring discrepancies
Edits and corrects daily claim forms for completeness and accuracy of payer-required detail
Monitors primary and secondary billing sequences to ensure compliance with written procedures and third party billing requirements
Validates billing data in electronic clearinghouse database prior to electronic transmission to payers
Timely processes EOB’s and Remittance Advice(s) on a daily basis
Processes sequential billing of claims after the primary insurance payment is received
Coordinates with insurance carriers and third party payers to get resolution of pended and inappropriately denied claims
Responsible for appealing inappropriate denials in writing & notifying PA Department of Insurance when the payer fails to meet contractual obligations.
Monitor hold and reject buckets in Clearinghouse on a daily basis to send out claims that have been corrected and are ready for claim submission.
Reviews and researches overpayments weekly to resolve credit balances. Responsible for generating proper documentation to refund or adjust the account to resolve the credit balance according to WGH policy.
Responds to verbal and written inquiries from patients, family members, insurance companies, employers and other parties regarding charges or billing issues per WGH’s
Requirements:
High School Diploma or equivalent required. Associates degree in medical or business field preferred.
Two years of health care related billing and collection experience (hospital preferred) or equivalent experience in claims process for an insurance company.
Certified Revenue Cycle Specialist – Institutional (CRCS-I) or equivalent; or must receive certification within eighteen (18) months of acceptance into the position.
Must be able to work independently, meet deadlines and manage changing workloads.
Posses above average knowledge of billing and collection regulations & protocols.