Healthcare Claims Representative
Company: AppleOne
Location: Saint Charles
Posted on: August 6, 2022
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Job Description:
The Patient Account Representative I maintains follow-up and
collection activity including letters, telephone and personal
contact. Maintains patient financial file and documentation,
advises, informs and assists the patient/guarantor/family in regard
to hospital financial policies. Performs other various clerical
responsibilities as may be assigned. Identification of problem or
un-collectible accounts required. Hospital or Doctors Office
Experience Demonstrates Competency in the Following Areas:1.
Spot-checks documentation to ensure accuracy to ensure that all
balances are correct before mailing to patient/guarantor.2. Is
responsible for follow-up on all assigned accounts of in-house
and/or discharged patients.3. Maintains and keeps current accounts
assigned to collection work list to ensure a prompt follow-up.4.
Begins follow-up on accounts no less than 20 days from billed date
and continues every 14 days or less as required. (When working
accounts with multiple unpaid cycles/claims all cycles must be
worked.)5. Clearly documents in the patient accounting system every
contact made to or by third party payor, patient, family or
employee.6. Advises Business Office Manager of problem payors
and/or accounts at time an issue is identified which may result in
non-payment of claims.7. Monitors and records all payments made on
patient accounts, prorates balance to next payor or patient, and
changes financial class appropriately.8. Notes payment
discrepancies and resolves within 48 hours.9. Identifies inaccurate
guarantor/admit data to Business Office Manager if consistent to
ensure appropriate corrective action at front end occurs.10. Is
responsible for making sure that accounts have been properly worked
before moving to next financial class for insurance or patient
responsibility.11. Audits for accuracy and prepares all adjustments
and/or refunds within 48 hours of discrepancy being identified and
submits to manager for approval according to established
departmental procedures.12. Scans or submits information to be
scanned in patient files as needed to keep all supporting
documentation.13. Performs any other duties as assigned by the
Business Office Manager.14. Verifies and submits to Biller any
additional information needed when billing (claim forms, EOBs,
Medical Records, etc.)15. Sends request to patient for any
necessary information (claim forms, account status, coordination of
benefits, divorce decrees, termination of benefits letters,
etc).16. Timely request bills for all secondary insurance and
request re-files for any missing or lost bills.17. Correspondence
is answered within 48 hours of receipt. AppleOne is proud to be an
Equal Opportunity Employer. Pursuant to applicable state and
municipal Fair Chance Laws and Ordinances, we will consider for
employment qualified applicants with arrest and conviction
records.0-1 years
Keywords: AppleOne, Saint Charles , Healthcare Claims Representative, Healthcare , Saint Charles, Missouri
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