Patient Account Representative - Claims Follow Up/ Collections
University Medical Center of Southern Nevada (UMC), Las Vegas, Nevada, us, 89105
Position
Position Summary As an academic medical center with a rich history of providing life-saving treatment in Southern Nevada, UMC serves as the anchor hospital of the Las Vegas Medical District, offering Nevada’s highest level of care to promote successful medical outcomes for patients. We are home to Nevada's ONLY Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center, and Transplant Center. We are a Pathway Designated facility by ANCC, and we are on our journey to Magnet status.
Overview EMPLOYER-PAID PENSION PLAN (NEVADA PERS) Competitive Salary & Benefits Package
Position Summary: Bills insurance companies, governmental agencies and individual patients; follows up on open accounts; resolves payment problems; and finalizes accounts.
Qualifications Education/Experience:
Equivalent to high school graduation and two (2) years of hospital and/or physician clinic billing and/or follow-up experience.
Additional Position Requirements
Minimum of 2 years recent experience (within 3 years) of hospital claims and follow up experience; OR a minimum of 2 years of Physician claims and follow up experience.
Current or recent (within 3 years) commercial payer claims appeal experience
Minimum of 2 years of hospital/physician billing denials and appeal experience in account follow-up
Minimum of 2 years of experience working with Managed Care payers and contracts
Minimum of 2 years' experience in reconciliation of accounts including payments, adjustments, denials, and underpays
Minimum of 2 years' experience in patient accounting software systems
Proficient in Microsoft Excel
Able to interpret managed care contracts and perform discrepancy workups
Proficient analytical skills to resolve complex claims
Able to read explanation of benefits proficiently
Must have good communication skills
EPIC EHR experience
Proficient in scanning and understanding the process of follow-up, denials and appeals
Knowledge, Skills, and Abilities Knowledge Of:
Office theories and principles; medical terminology and procedures; insurance plans, governmental agencies and other social services; legal terminology and requirements; alternative pay sources; collection principles and techniques; department and hospital safety practices and procedures; patient rights; infection control policies and practices; handling, storage, use and disposal of hazardous materials; department and hospital emergency response policies and procedures.
Skill In:
Applying customer service techniques; applying billing practices; monitoring and tracking payments; reviewing accounts and making corrections and adjustments; resolving problems with accounts; establishing effective payment arrangements; performing basic mathematical computations; preparing legal documentation such as notices, liens and subpoenas; developing interpersonal relations with vendors, agencies and patients; using computers and related software applications; using office equipment such as phones, copiers, facsimiles and adding machines; communicating effectively with a wide variety of people from diverse socio-economic and ethnic backgrounds; establishing effective working relationships with all personnel contacted in the course of duties; efficient, effective and safe use of equipment.
Physical Requirements and Working Conditions Mobility to work in a typical office setting and use standard office equipment; stamina to remain seated for long periods; vision to read printed materials and a VDT screen, and hearing and speech to communicate effectively in person and over the telephone. Strength and agility to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.
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Position Summary As an academic medical center with a rich history of providing life-saving treatment in Southern Nevada, UMC serves as the anchor hospital of the Las Vegas Medical District, offering Nevada’s highest level of care to promote successful medical outcomes for patients. We are home to Nevada's ONLY Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center, and Transplant Center. We are a Pathway Designated facility by ANCC, and we are on our journey to Magnet status.
Overview EMPLOYER-PAID PENSION PLAN (NEVADA PERS) Competitive Salary & Benefits Package
Position Summary: Bills insurance companies, governmental agencies and individual patients; follows up on open accounts; resolves payment problems; and finalizes accounts.
Qualifications Education/Experience:
Equivalent to high school graduation and two (2) years of hospital and/or physician clinic billing and/or follow-up experience.
Additional Position Requirements
Minimum of 2 years recent experience (within 3 years) of hospital claims and follow up experience; OR a minimum of 2 years of Physician claims and follow up experience.
Current or recent (within 3 years) commercial payer claims appeal experience
Minimum of 2 years of hospital/physician billing denials and appeal experience in account follow-up
Minimum of 2 years of experience working with Managed Care payers and contracts
Minimum of 2 years' experience in reconciliation of accounts including payments, adjustments, denials, and underpays
Minimum of 2 years' experience in patient accounting software systems
Proficient in Microsoft Excel
Able to interpret managed care contracts and perform discrepancy workups
Proficient analytical skills to resolve complex claims
Able to read explanation of benefits proficiently
Must have good communication skills
EPIC EHR experience
Proficient in scanning and understanding the process of follow-up, denials and appeals
Knowledge, Skills, and Abilities Knowledge Of:
Office theories and principles; medical terminology and procedures; insurance plans, governmental agencies and other social services; legal terminology and requirements; alternative pay sources; collection principles and techniques; department and hospital safety practices and procedures; patient rights; infection control policies and practices; handling, storage, use and disposal of hazardous materials; department and hospital emergency response policies and procedures.
Skill In:
Applying customer service techniques; applying billing practices; monitoring and tracking payments; reviewing accounts and making corrections and adjustments; resolving problems with accounts; establishing effective payment arrangements; performing basic mathematical computations; preparing legal documentation such as notices, liens and subpoenas; developing interpersonal relations with vendors, agencies and patients; using computers and related software applications; using office equipment such as phones, copiers, facsimiles and adding machines; communicating effectively with a wide variety of people from diverse socio-economic and ethnic backgrounds; establishing effective working relationships with all personnel contacted in the course of duties; efficient, effective and safe use of equipment.
Physical Requirements and Working Conditions Mobility to work in a typical office setting and use standard office equipment; stamina to remain seated for long periods; vision to read printed materials and a VDT screen, and hearing and speech to communicate effectively in person and over the telephone. Strength and agility to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this classification.
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