Position Title:Patient Account Representative Lead - Pre-Visit Services/Authorizations
Department:Pre-visit Services
Job Description:New to OU Health? Ask your recruiter about our competitive wages and total rewards package. Remote Eligibility: Candidates must reside and work full-time in
OK before their first day of employment.
SHIFT: M-F, Days. Will be required on-site as needed, at least monthly.**The ideal candidate will have leadership experience, as they will be the subject-matter-expert for their small team when it comes to processing authorizations and referrals. Minimum of 3 years in authorizations is preferred.**
General Description: Under general supervision, may participate in any or all aspects of the patient processing and accounts receivable functions of the organization including billing, charge entry, collection, registration, scheduling, follow-up, coding, payment posting and credit balance resolution. May reconcile daily IDX system receivables reports. May balance monthly transactions and provide summaries to faculty and department administration.
Essential Responsibilities:Patient schedulingPatient registration- Review patient admitting records and extracts relevant information
- Records patient identification and demographic information in the computerized billing system
- Contacts agency representatives to verify type and extent of coverage.
Charge entry- Performs preliminary review of source documents to determine that sufficient data are present for processing
- Using alphanumeric keyboard, transcribes and/or verifies data from source documents to the medium used for entering data into the computer
- Batch charges
- Generate cash totals
- Enter charges
- Balances batches by comparing batch proofs to source documents and hash totals
Billing- Works with all areas of the organization in getting any necessary or requested documentation for patients, insurance carriers or other areas.
- May interact with hospital patient accounting or records personnel to obtain patient demographic or other billing information
- Operates hospital information system terminal to obtain patient demographic information, patient insurance information and status of approvals or denials
- Completes processing of all inpatient and outpatient documents received on a daily basis
- Assists in resolving department problems with IDX billing
- Maintains records of charges, payments, third party charges, etc.
Collection- Answers patient's questions regarding statements, agency coverage, etc.
- Handles correspondence regarding collection activity and records results
- Identify patient accounts for collection action when accounts become delinquent or when unable to contact patient or responsible party
- May receive patient payments and/or issue payment receipts
Coding- Record CPT codes on billing forms
- Record ICD-9 codes on billing forms
Follow-up- Initiates contact with patients and/or third party carriers if there is a delay in responding to statements or claims
- May process incoming and outgoing mail
- May receive incoming telephone calls and resolve issues communicated
- Records results of mail and telephone contacts on the computer billing system
- Contacts insurance carriers regarding non-payment and/or improper payment of claims
- Reviews denials
- Interfaces with patients, physicians, and others regarding professional billing operations and funds
Payment posting- Post receipts to proper patient accounts
- Posts denials
- Compare batch proofs and source documents for accuracy
Reporting- Assists in reviewing and balancing IDX transaction reports for administration
- Reconciles daily IDX receivables reports
- Prepares billing statements from statistical data
Credit balance resolution- Review daily billing and accounts receivable credit balance reports
- Prepare daily refund check requests
- Prepare other daily credit balances other than refunds
- Post refund checks to patient accounts
- Mail refund checks with supporting documentation
Personnel Supervision.
- Leads and trains employees.
General Responsibilities:- Performs other duties as assigned.
Minimum Requirements:Education: High School Diploma or GED.
Experience: At least 5 years of experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other billing system) required.
Licensure/Registrations/Certifications Required: None required.
Knowledge, Skills & Abilities:- Proven ability to manage a team of professionals and lead a departmental function
- Excellent verbal and written communication skills
- Proficient with the use of Microsoft Office tools
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Current OU Health Employees - Please click HERE to login.OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.