Billing Follow-Up Patient Accounts Representative (Home Health)

The Patient Accounts Representative supports hospital billing and follow-up for Home Health and Hospice services by ensuring timely and accurate submission of inpatient and outpatient claims to government and non-government payers. The role focuses on resolving claim issues to accelerate cash collections and maintain accurate revenue cycle operations.

Key Responsibilities

• Submit inpatient and outpatient electronic and paper claims (UB-04 and 1500) to appropriate payers.
• Resolve billing errors and warnings identified in the patient accounting and billing system.
• Ensure claim information is complete and accurate to support cash collections.
• Analyze billing system information to determine next steps for account resolution.
• Correct and resubmit rejected claims.
• Place unbillable claims on hold and communicate needed information to hospital departments.
• Process late charge claims and submit corrected claims when needed.
• Handle complex billing scenarios including interim, self-audit, combined, and split billing.
• Review imported claims and either bill or hold them for further review.
• Meet productivity and quality standards established by leadership.
• Follow up on unpaid or unprocessed claims until resolution is achieved.
• Generate correspondence to insurance companies or patients as needed.
• Maintain spreadsheets and documentation accurately and clearly.
• Explain benefits to coworkers, physicians, and patients.
• Contact payers by phone, internet, and mail for claim follow-up.
• Post accurate adjustments according to billing policies, procedures, and payer explanations of benefits.
• Resolve questions related to charging and services provided.
• Complete cross-training and special projects as assigned.
• Follow HIPAA guidelines and maintain confidentiality of patient and hospital information.