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Patient Accounts Rep

Company: Beaumont Hospitals
Location: Waterford
Posted on: November 13, 2021

Job Description:

GENERAL SUMMARY: Responsible for preparing and processing professional and facility billing for Beaumont Health to third-party payors, according to established policies and procedures. ESSENTIAL DUTIES: * Reviews daily census from Hospital System to verify that charges have been submitted by physician for professional services rendered at Beaumont Health. * Verifies patient demographics, authorization numbers, admit and discharge dates from Hospital System, and enters this data into the Practice Management Software. * Inputs hospital and office charges into billing software after accurately coding diagnoses and/or procedures (ICD-9/CPT-4) in a timely manner. Corrects and updates all registration information prior to billing, as needed. Inputs authorization numbers and hospital admission and discharge dates, prior to billing. * Verifies insurance eligibility, obtains referrals and reviews physical documentation for appropriate code category. Pre-certifies and verifies all insurances for surgical and hospital patient services. * Runs day end reports and reviews billed material for accuracy and balancing. * Collects applicable co-pays and/or balances and provides receipts to patients. Post monies received in office prepares bank deposit and may initiate payment plans with patients. Collects payment on non-covered procedures and procedures that do not pass medical necessity (per Medicare policies), prior to patient's departure. Completes ABN, as necessary. May assist patient with financial assistance application. * Responds to billing inquiries from patients, physicians, insurance carriers and System Business Office. Explains line detail on patient account histories. * Works collection module in a timely and consistent basis. This may require actively seeking patient payments via letters, phone calls or direct conversation during clinic visits. * Interacts with Medical Records Department to obtain documentation necessary to support hospital billing. * Works claims on hold in an effort to ensure clean claims and reduce denials from payors. * Conducts concurrent and retrospective review of patient medical record to ascertain accurate coding and charge capture. * May assists with incoming mail and faxes. May handles petty cash and ensures reconciliation. * Assists in training and orientation of new personnel and insurance changes to existing staff and physicians. * Reviews insurance updates and notifications and forwards information to Business Office Assistants; i.e. physician primary care monthly listings. May assist in third-party payor site reviews. * Attends billing seminars and reviews current literature to maintain proficiency with CMS, State, Federal, and Managed Care Carrier regulation. Works closely with Process Improvement Coordinators and Compliance Coordinator to ensure comprehensive compliant coding and claims resolution. * Performs all other responsibilities, as assigned by department management to include all Business Office Assistant job functions. * Verifies with Compliance Coordinator accuracy of coding. Works with SBO and Contracting regarding proper charge capture and payment. STANDARD QUALIFICATIONS * Requires a high school diploma or equivalent. Certified Coding training is desired. * Requires a minimum two years' medical billing experience in hospital or physician practice setting. Requires demonstrated proficiency with ICD-9, CPT-4, and HCPCS coding. Familiarity with CMS regulations and payor requirements is desired. * Physician Specialty experience is dependent upon on the clinic assignment. * Certified Coder credential preferred, i.e. CCA, CPC, CCS-P, RHIT or RHIT eligible within six months of employment. Other Qualifications: * Requires the interpersonal skills necessary to effectively and regularly communicate with patients and all levels clinic and hospital staff regarding sensitive medical and financial issues and concerns. * Requires excellent communication skills and the ability to ask for and obtain money from patient and/or responsible parties in a courteous and professional manner. * Requires the ability to maintain confidential patient health information. * Requires the ability to treat patients and others with patience, respect and understanding regardless of their status or position. * Requires basic keyboarding skills, familiarity and demonstrated proficiency with hospital coding/billing information systems, practice management software and electronic medical record systems.

Keywords: Beaumont Hospitals, Waterford , Patient Accounts Rep, Other , Waterford, Michigan

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