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Company: Pinehurst Surgical Clinic PA
Location: Pinehurst
Posted on: February 23, 2021

Job Description:

SUMMARY: The Patient Accounts Representative is responsible for working and maintaining patient accounts as assigned by Accounts Receivable Manager. Duties include interaction with internal and external customers to resolve unpaid claims with insurance or personal balances with appropriate follow-up. Adherence to the Flawless Reimbursement system is required. Ultimate responsibility is to maximize reimbursement for Pinehurst Surgical as a group practice and to determine that the insurance carrier has paid correctly on all services per contractual or non-contractual agreements. All duties must be performed with professional, world-class customer service as a team member and in an individual effort to support the Accounts Receivable system. Patient Accounts Representative reports directly to Accounts Receivable Manager. Position Requirements

  • A/R Management
  • Maintain insurance aging report > 120 days to 9.5% for the designated specialty
  • Work denials in all Athena Buckets to achieve the 4% KPI
  • Work with coders to identify coding issues regarding claim denials and educate the applicable department
  • Prepare for monthly department AR meetings
  • Insurance Carrier Management
  • Become knowledgeable with the various federal and commercial medical policies and educate the Patient Financial Service team and Clinical Managers accordingly
  • Develop relationships with the various insurance carriers that are dealt to develop a collegial working relationship
  • Develop an investigative approach in dealing with the insurance carriers and don't take no for an answer. Take every no to the next level and insist on dealing with a supervisor
  • Clinical Department Relationship/Team Building
  • Develop a relationship with the assigned department and communicate issues as they arise
  • Assist assigned Department with all coding, payment, and claim questions
  • Attend monthly Departmental meetings and prepare a working agenda
  • Note the To Do's from the meeting and follow-up with the department manager within 24 hours of the meeting. Preferred Qualifications Education
  • Prefer candidate with 2-year degree in related field or equivalent work experience Experience:
  • 1-3 years' experience of medical billing required.
  • Previous experience working with the public with ability to maintain composure when confronted with fast-paced and stressful situations
  • Knowledge and understanding of insurance and managed care plans.
  • Knowledge and understanding of billing and payment procedures, rules, and regulations of contractual and non-contractual insurance carriers
  • Knowledge and understanding of State and Federal insurance regulations
  • Possess a basic understanding of how use ICD-9, HCPCS, and CPT coding books and or applications relating to industry standards.
  • Appropriate English usage in spelling, grammar, and punctuation in communicating with both insurance carriers and internal management.
  • Knowledge of basic math concepts with ability to operate standard office machines and computer and balance debits and credits. 9. Ability to speak clearly and concisely with pleasant attitude, and present a neat appearance.
  • Ability to maintain confidential information.
  • Ability to read, comprehend, and follow oral and written instructions
  • Ability to learn quickly in a fast paced healthcare environment. Physical guidelines include ability to work at a computer terminal six to eight hours at a time. NOTE: This document is intended to describe the general nature and level of work performed. It is not intended to serve as an exhaustive list of all duties, skills, and responsibilities required of personnel as assigned by Accounts Receivable Manager.


Keywords: Pinehurst Surgical Clinic PA, Fayetteville , PATIENT ACCOUNT REP, Other , Pinehurst, North Carolina

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