Senior Patient Account Rep - PB EDI Specialist
OU Health, Oklahoma City, OK, United States
Position Title: Senior Patient Account Rep - PB EDI Specialist
Department: Revenue Integrity
Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment.
Ask your recruiter about our competitive wages and total rewards package.
SHIFT: M-F, 8a-5p (some flexibility may be available).
Senior Patient Account Rep - Physician Billing (PB) Electronic Data Interchange (EDI) Clearinghouse Specialist Ideal candidate will have experience with Experian and electronic claim submission/rejection.
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 scheduling
Patient registration
Review patient admitting records and extract relevant information
Record patient identification and demographic information in the computerized billing system
Contact agency representatives to verify type and extent of coverage.
Charge entry
Perform preliminary review of source documents to determine that sufficient data are present for processing
Using alphanumeric keyboard, transcribe and/or verify data from source documents to the medium used for entering data into the computer
Batch charges
Generate cash totals
Enter charges
Balance batches by comparing batch proofs to source documents and hash totals
Billing
Work with all areas of the organization to obtain 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
Operate hospital information system terminal to obtain patient demographic information, patient insurance information and status of approvals or denials
Complete processing of all inpatient and outpatient documents received on a daily basis
Assist in resolving department problems with IDX billing
Maintain records of charges, payments, third party charges, etc.
Collection
Answer patient questions regarding statements, agency coverage, etc.
Handle correspondence regarding collection activity and record 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 form
Record ICD-9 codes on billing form
Follow-up
Initiate 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
Record results of mail and telephone contacts on the computer billing system
Contact insurance carriers regarding non-payment and/or improper payment of claims
Review denials
Interface with patients, physicians, and others regarding professional billing operations and funds
Payment posting
Post receipts to proper patient accounts
Post denials
Compare batch proofs and source documents for accuracy
Reporting
Assist in reviewing and balancing IDX transaction reports for administration
Reconcile daily IDX receivables reports
Prepare 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
General Responsibilities
Perform other duties as assigned.
Minimum Requirements
Education: High School Diploma or GED.
Experience: 3-5 years of experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other billing system) required.
Licensure/Certifications/Registrations Required: None required.
Knowledge, Skills, and Abilities
Attention to detail
Excellent verbal and written communication skills
Proficient with the use of Microsoft Office tools
OU Health is an equal opportunity employer.
We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more.
#J-18808-Ljbffr
Department: Revenue Integrity
Remote Eligibility: Candidates must reside and work full-time in AR, KS, MO, OK, or TX before their first day of employment.
Ask your recruiter about our competitive wages and total rewards package.
SHIFT: M-F, 8a-5p (some flexibility may be available).
Senior Patient Account Rep - Physician Billing (PB) Electronic Data Interchange (EDI) Clearinghouse Specialist Ideal candidate will have experience with Experian and electronic claim submission/rejection.
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 scheduling
Patient registration
Review patient admitting records and extract relevant information
Record patient identification and demographic information in the computerized billing system
Contact agency representatives to verify type and extent of coverage.
Charge entry
Perform preliminary review of source documents to determine that sufficient data are present for processing
Using alphanumeric keyboard, transcribe and/or verify data from source documents to the medium used for entering data into the computer
Batch charges
Generate cash totals
Enter charges
Balance batches by comparing batch proofs to source documents and hash totals
Billing
Work with all areas of the organization to obtain 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
Operate hospital information system terminal to obtain patient demographic information, patient insurance information and status of approvals or denials
Complete processing of all inpatient and outpatient documents received on a daily basis
Assist in resolving department problems with IDX billing
Maintain records of charges, payments, third party charges, etc.
Collection
Answer patient questions regarding statements, agency coverage, etc.
Handle correspondence regarding collection activity and record 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 form
Record ICD-9 codes on billing form
Follow-up
Initiate 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
Record results of mail and telephone contacts on the computer billing system
Contact insurance carriers regarding non-payment and/or improper payment of claims
Review denials
Interface with patients, physicians, and others regarding professional billing operations and funds
Payment posting
Post receipts to proper patient accounts
Post denials
Compare batch proofs and source documents for accuracy
Reporting
Assist in reviewing and balancing IDX transaction reports for administration
Reconcile daily IDX receivables reports
Prepare 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
General Responsibilities
Perform other duties as assigned.
Minimum Requirements
Education: High School Diploma or GED.
Experience: 3-5 years of experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other billing system) required.
Licensure/Certifications/Registrations Required: None required.
Knowledge, Skills, and Abilities
Attention to detail
Excellent verbal and written communication skills
Proficient with the use of Microsoft Office tools
OU Health is an equal opportunity employer.
We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more.
#J-18808-Ljbffr