Position Summary:
Each employee who participates in the coding, billing or claims submission process, from the initial receipt of a physician order to the receipt of payment for services, shall accurately and honestly perform his/her functions to ensure that accurate claims are submitted, and the organization retains only those funds to which it is legally entitled.
The Patient Account Representative (PAR) will be responsible for efficient and effective follow-up on third party payer to determine why payment has not been received within a specified amount of time.
The PAR will review patient accounts files as necessary for accuracy of information, necessary signatures, pre-certification, insurance benefits, and deposits made.
The PAR will submit electronic and hard copy claims in an accurate and timely, and make all necessary corrections to claims that do not pass the billing edits and payer requirements.
The PAR will contact payers regarding unpaid claims and research and/or ensure that questions and requests for information are addressed in a timely and professional manner to ensure resolution and reimbursement.
The PAR will ensure timely, effective, and thorough management of claims to ensure full, expected reimbursement for services provided and will prioritize claims based on aging and outstanding dollar amounts or as directed by management.
The PAR will answer phone inquiries regarding bills, charges and account status and compose routine correspondence, memos, letters, etc.
The PAR must be willing to coordinate alternate housing within the facility in advance of shifts when inclement weather potential threatens the ability to get to the facility.
The PAR may be required to report back to work during any emergency situation i.
e.
mass casualty, internal disaster, etc.
All organizational staff, including this position, are specifically required as a condition of continued employment to make advance preparations for their families and pets in the event of weather emergencies such as Hurricanes and flooding threats.
Any staff member can be determined as essential staff required to report to the facility during these events.
In many cases this means reporting and sleeping at the facility before, during and after a weather emergency.
By signing this job description, the staff member accepts this responsibility of readiness to report to work during any designated emergency staffing situation.
CMC staff members operate as one team meeting the healthcare needs of our communities, thus this position will on occasion complete other duties as assigned beyond those designated in this primary job description which may include “float” coverage at an alternate facility, department or assignment.
Qualifications
Assessment of overall credit worthiness by review of a consumer credit report is required.
Education:
High school diploma required.
Associates degree in health-related field preferred.
Experience:
At least one year of medical billing related experience required.
Previous experience in Physician Billing preferred.
Special Skills:
Demonstrated proficiency with Microsoft Outlook, word, Excel, Explorer and PowerPoint preferred.
Exemplary core customer service skills strongly required.
Strong organizational skills.
Strong verbal and written communication skills required.
Ability to consistently exercise independent judgment required.
Working Conditions:
Stress level high due to multiple demands frequently occurring simultaneously.
Physical surroundings pleasant and comfortable
Generally contained office type environment
Most work performed while sitting, however, a moderate amount of walking and moving around within a confined area occurs
Physical Requirements:
Light-Medium - While performing the duties of this job, the employee is frequently (activity or condition exists from 1/3 to 2/3 of the time) required to stand, sit, and walk; frequently to use hands, fingers; and frequently to talk or hear.
The employee must exert 15 to 20 pounds of force occasionally (activity or condition exists up to 1/3 of the time), and/or 5 to 10 pounds of force frequently, and/or greater than negligible up to 5 pounds of force constantly to move objects.
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
Ability to hear to process instructions and safety code and alarms required.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job and will be assessed by post offer Employee Health fit-for-duty review.
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