Patient Account Representative

Truckee, 96161 | 04/30/2019 | Ad id: 7-0000412616

Patient Account Representative
Rate of Pay: 
$20.28 / HR + DOE

SUMMARY: Responsible for submitting accurate claims, ensuring timely reimbursement from various third-party payers and patients, and confirming proper documentation occurs in the facility’s billing system. Collaborates with Revenue Cycle departments and third-party payers on efforts related to follow-up, denials, and appeals.

  • Examines denied and underpaid claims to determine reasons for discrepancies.
  • Communicates via phone calls and web-portals, directly with payers to follow up on outstanding claims, resolves payment variances, and achieves timely reimbursement.
  • Provides payers with specific reasons for suspected underpayments and reviews denial reasons given by payers. Documents patient account (HAR) with status and expected payment amounts.
  • Works with management to identify, trend, and address root causes of denials; helps pinpoint strategies for reducing Accounts Receivables (A/R).
  • Maintains a thorough understanding of federal and state regulations, as well as specific payer requirements and explanations of benefits, in order to identify and report billing compliance issues and payer discrepancies.
  • Keeps current using payer bulletins, coding and billing training and manuals.
  • Updates and maintains accurate files on each payer, including contact names, addresses, phone numbers, and other pertinent information. Notifies PFS managers of changes to update other TFH Departments.
  • Thoroughly documents all interactions with payers.
  • Handles all payer-specific communications, including telephone and email, from payers and departments within the business office.
  • Participates in quality improvement efforts on an ongoing basis. Strives to exceed goals established with leadership, typically working a minimum of 40 – 50 accounts per day.
  • Demonstrates initiative and resourcefulness by gathering information and examples about issues and helping to document recommendations for system fixes.
  • Communicates trends and issues to management and helps to monitor and validate fixes.
  • Understands and maintains compliance with HIPA guidelines when handling patient information.
  • Performs other duties as assigned.
  • Demonstrates System Values in performance and behavior.
  • Complies with System policies and procedures.

EDUCATION AND EXPERIENCE: High school diploma or general education degree (GED). Minimum of two years recent billing and follow-up experience in hospital and/or physician clinical areas required. Preferred: Prior experience in Medicare or Medi-Cal (Medicaid) billing, EPIC Hospital Billing and/or Physician Billing.

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About Tahoe Forest Health System
Joseph family created a legacy that would benefit our community for generations to follow. The community quickly rallied around the Joseph’s donation of land for a new hospital. Sixty-six years later, Tahoe Forest Health System continues to thrive under this heritage of philanthropy.
Through continued generous community support, Tahoe Forest Health System is able to offer a wide variety of high-quality programs and services.
Tahoe Forest Hospital offers 24-hour emergency care, an ambulatory surgery center, intensive care, orthopedics and sports medicine, a medical/surgical unit, women and family center, home health and hospice programs, a health clinic, cancer center, long term care center, children’s center, a health and sports performance center, as well as a variety of community health outreach programs.
Tahoe Forest Hospital is a not-for-profit rural health care facility and designated critical access hospital. It is fully accredited by the Healthcare Accreditation Facilities Program and licensed by the State of California Department of Health Services.
Tahoe Forest Hospital has 25 acute care beds and 36 long-term care beds. Our service area covers six rural counties, two states and approximately 3,500 square miles, reaching the communities of Truckee, North Lake Tahoe, Donner Summit, the Sierra Valley in California, and Incline Village in Nevada.
A vital resource of Tahoe Forest Health System is Incline Village Community Hospital located in Incline Village, Nevada, and serving North Lake Tahoe, Kings Beach, Crystal Bay and Incline Village. It is a 4-bed critical access hospital offering 24-hour emergency care as well as laboratory, diagnostic and surgical capability, physical therapy services, health clinic and a sleep disorder center.