Here at NSCH we believe in providing high quality medical treatment to our patients. Providing the superlative healthcare is a difficult accomplishment, which takes commitment from a collaboration of talented individuals. NCSH plans to provide employees the encouraging work environment that is constantly looking to accentuate innovative healthcare. We welcome you to come be apart of our team.
Patient Account Representative – Full Time
- High School Diploma or GED
- Work requires knowledge of health care billing and collection processes including federal and state collection laws, collection practices and techniques at a level generally acquired through min. 3-5 years on-the-job training or experience in billing Medicare, Medicaid, Blue Cross, Workers Compensation and other Commercial insurances in a hospital healthcare environment.
- Full understanding of UB-04 claim form requirements, ICD-9, ICD-10, CPT and HCPCS coding nomenclature and standards
- Basic knowledge of medical terminology, human anatomy & physiology.
- Strong problem solving, analytical and multi-tasking skills required.
- Excellent customer service skills
- Works and processes the Billing functions, including the compiling of claims to be billed, the clearing of Claim Check Edits, and the electronic upload of claims to be submitted to our Claims Clearinghouse for electronic submission. Also processes the daily paper claims submissions for primary and secondary claims.
- Monitors accounts on ‘unbilled’ status and alerts Manager of overdue accounts for escalation resolution.
- Follows up on accounts assigned to determine if the claim has been accepted and processed for payment or denied. Reviews claim rejections and re-bills accounts when appropriate.
- Effectively and timely identifies the root cause of non-payment denials and works with the insurance company, the patient and allied healthcare support staff to find resolution to claim denials, making all necessary claim and account corrections to ensure the full reimbursement of services rendered.
- Appropriately escalates denials via the payer Appeals process, and obtains all needed documentation to support the appeal escalation.
- Contacts insurance carriers, patients or guarantors at established intervals to follow-up on status of delinquent accounts, determines the reason of delay and expedites payment.
- Responds in a timely and effective manner to all correspondence inquiries received on assigned accounts.
- Uses effective time management skills to prioritize work flows and respond to claim follow-up in a timely manner.
- Effectively works and processes credit balances and submits needed Refund requests.
- Works on special projects as assigned and seeks Managers guidance to help achieve departmental goals.
- Provides specific timely feedback to Manager regarding denial trends, system and payer specific issues.
- Helps Manager identify front end solutions to claim denials geared at improving Clean Claim submission and decrease denials.
- Keeps up to date of assigned payer regulation changes, notices and bulletins and ensures all information is shared with BO Manager and staff in a timely manner.
- Attends in-services and seminars to stay abreast of current issues affecting reimbursement, billing and collections as it pertains to payer assignment.
- Provides patient-focused customer service to assist patients with questions or problems in a courteous and effective manner.
- Adheres to all Hospital Policies and Procedures, specifically Guidelines for Appropriate Conduct, Corporate Compliance, Diversity, and Confidentiality.
- Demonstrates the spirit of the philosophy, mission, and values of the hospital through words and actions and implements them into departmental processes, programs, and the working environment.
- Adheres to Confidentiality Policy.
- Maintains cooperative working relationships with all customers and responds to requests for information in a prompt and courteous manner.
- Adheres to the hospital’s “Guidelines for Appropriate Conduct” in the HR Manual.
- Displays honesty and mutual respect when communicating with peers and other departments.
- Follows through on problems that may compromise effective job performance by using appropriate chain of command.
Equal Opportunity Employer
The North Carolina Specialty Hospital is an equal opportunity employer and will not discriminate against any applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status or any other consideration made unlawful by federal, state or local laws.
Only qualified applications will be considered.
APPLICATIONS accepted only for open positions posted here.