Billing and Insurance Specialist Job In Lodi, California
Patient Account Representative INext Steps... Apply Now
DEPARTMENT: Patient Financial Services
TITLE: Patient Account Representative I
REPORTS TO: Supervisor and/or Director of Patient Financial Services
SUMMARY: The Patient Account Representative I is responsible for patient billing, claims processing, and follow up of final billed accounts.
EDUCATION, TRAINING_AND EXPERIENCE:
1. High school graduate or equivalent.
2. 2-year patient accounts receivable and patient/claims payable experience
3. 2-year insurance regulation & billing experience for governmental and non-governmental payers.
4. Ability to type 45 wpm
5. Ability to use 10 key by touch
6. Must have command of the English language both verbally and in written communications
7. Strong interpersonal, listening, and communications skills
8. Must have experience and be proficient with Excel spreadsheets
9. Demonstrated organization and prioritization skills
1. College Graduate
2. Working knowledge of Cerner billing system.
MAJOR DUTIES AND RESPONSIBILITIES:
1. Participates in and contributes to hospital wide Customer Satisfaction program.
2. Responsible for submitting claims to insurance companies for payment within timely billing limits both electronically and hard copy.
3. Professionally, assertively and effectively follows-up on final billed accounts for payment and resolution.
4. Reviews all documents for accuracy and completeness based on the specific regulatory or contractual requirements of each account to obtain payments based on insurance coverage before making contact with the payer.
5. Works with necessary parties to ensure all information and paperwork required for billing and payment is obtained.
6. Is responsible for own education and retaining the necessary working knowledge of all patient accounting functions to perform efficiently in this role.
7. Requires timely and accurate documentation of current activities on all assigned accounts encountered.
8. Follows established policies and procedures when processing claims, refunds, correspondence, mail returns, and Medicare Credit Balance report submitted quarterly, and other related paperwork.
9. Communicates effectively and professionally with patients, government agencies and third party payers regarding account activity, i.e., payments and adjustments.
10. Accurately calculates debit/credit adjustments and has a complete understanding of the reimbursement methodology.
11. Processes the daily work queue reminders for a designated set of Accounts Receivables to ensure that required activities are performed in a timely manner.
12. Is responsible to research problem accounts and work with the direct report to ensure accounts are handled for timely resolution.
13. Works with patients and other departments diplomatically and professionally.
14. Works as a team member when problems are identified and participates in process improvements as necessary.
15. Demonstrates flexibility in performing other assignments or projects, as needed, to maintain operational efficiency.
16. Duties and responsibilities may be added, deleted or changed at any time at the discretion of the Director or designee, formally or informally, either verbally or in writing.
1. Conducts hospital and department business in an ethical and lawful manner, and is willing to report any knowledge of real or potential fraud or abuse according to the Lodi Health Compliance Code of Conduct.
2. Will not use or disclose individually identifiable health information of patients over and above that which is minimally required to perform your assigned position responsibilities.
3. Follows the appropriate actions in a timely manner required and outlined in the Hospital Policy and Procedure related to Identity Theft. Reports issues related to stolen identity or information breach by way of MIDAS reporting.
4. Treats others professionally, compassionately, and with dignity while promoting a positive work environment.
1. Typical business office environment, work is sedentary.
2. Works in clean, well-lighted, ventilated building.
3. May require trips to other departments and clinics within the hospital system.
4. Exposure to weather when traveling between hospital buildings and/or sites.
5. Potential exposure to infectious diseases, blood-borne pathogens, and hazardous substances.
6. Ability to work in close, quiet spaces.
1. Talking and hearing required to get information from various sources.
2. Walking, bending, stooping, reaching, lifting, pushing and pulling.
3. Must be able to safely lift a minimum of 35 pounds with assistance.
4. Visual acuity to safely use computer terminal and small business machines.
Lodi Health is a private, not-for-profit health system that strives to improve the quality of life in the community it serves - both in and beyond its walls. As a non-profit, unaffiliated health system, Lodi Health is able to reinvest in talent, technology and physicians to ensure patients receive quality and very personal care.
Since April of 1952 when the Lodi Memorial Hospital's doors first opened, until today, Lodi Health has evolved to meet the changing community's need. In 1952, there were 14,000 residents in Lodi. Today there are 65,000, and the area served beyond Lodi's boundaries has grown to more than a quarter million people.
Over the last 63 years, a lot has changed at Lodi Memorial Hospital. New buildings and wings have been erected. New technologies, like robotic-assisted surgery, have been introduced. Quality physicians and dedicated nurses have worked round the clock. Lodi Memorial Hospital became Lodi Health to encompass all of its services that provide the quality health care you need with the compassion and personal attention you want from the first day of your life and every day thereafter.
Our vision is to be the first choice for health care by providing the highest level of quality, care access, wellness and affordability through partnerships with patients, staff, physicians and the community we serve.
Now, Lodi Health is pleased to join the Adventist Health family, which allows for even greater service in Lodi and its surrounding communities.