The Patient Representative/Biller is responsible for managing balances due from patients, insurance carriers, and third-party payers. This role includes collecting patient payments, setting up payment plans and payroll deductions, following up on outstanding insurance denials, working on claim errors in the clearinghouse system, and posting patient and insurance payments for Home Care/Hospice accounts.
Key responsibilities include accurately posting payments, creating payment plans, communicating outstanding balances to patients and affected parties, coordinating financial assistance applications, understanding the revenue cycle and appropriate escalation pathways, contacting payers regarding unpaid accounts and denials, interpreting Managed Care/Commercial contracts and Medicare/Medicaid rules to ensure proper reimbursement, making required plan reimbursement adjustments, performing payment validation, appealing partially denied claims, and resolving claims errors in the clearinghouse system.
The position requires regular attendance, professional knowledge maintenance through continuing education, adherence to safety protocols, and compliance with vaccination requirements as per hospital policy.
Candidates must have effective oral and written communication skills in English, basic computer proficiency including email and use of Electronic Health Record tools, and the ability to adapt quickly to changing situations. A high school diploma or equivalent is required. At least 1 year of experience in medical claims recovery and/or collections with basic knowledge of billing and collections rules is preferred. Strong experience in Home Care and Hospice medical billing, collections, coding, and denial management is desirable. Ability to interpret policies and procedures and handle multiple tasks efficiently is necessary. A valid driver’s license and automobile liability insurance is required for positions involving travel.
Employees maintain professional development through internal and external education. The hospital promotes a supportive work environment aligned with core values and requires vaccinations with exemptions available for medical or religious reasons.
Location
Oklahoma, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago