Patient Accounting Representative F/T

Accounting / Finance Fremont, California


Description

Salary Range: $33.78 - $41.46 + applicable differentials 
Essential Job Responsibilities
Achieving Results;
  • Under the guidance of the Revenue Cycle Director, the Government and Commercial Billing Managers are tasked with billing various account types, encompassing HMOs, PPOs, Worker’s’ Compensation, Government Payers and Self-pay accounts.
  • Ensure all necessary documentation is present for billing patient accounts.
  • Coordinates with various insurance carriers to meet standard requirements, ensuring appropriate payment of claims and adherence to guidelines before billing.
  • Processes claims using the designated electronic billing system corresponding to the insurance plan, with any remaining claims billed in hardcopy to the relevant insurance carrier.
  • Collaborates with relevant personnel and hospital departments to ensure accurate diagnosis and procedure coding on claims.
  • Reviews past due accounts and associated documents to identify and access delinquency issues.
  • Conducts reviews of claims denials, identifies root causes, and takes necessary actions, including follow-ups and appeals in a timely manner.
Demonstrates Skills;
  • Investigates reasons for claim denials to uncover any unique circumstances contributing to payment delays and communicates with relevant parties for follow-up, potentially seeking assistance from Payer Contracting, Case Management, and Health Information Management (HIM)/Coding departments.
  • Executes a comprehensive array of tasks, potentially rotating assignments or specializing in a particular area as needed.
  • Demonstrates proficiency in all computer systems essential for completing job responsibilities and comprehends the integration of information across all financial systems.
Planning and Coordinating;
  • Responsible for daily claims processing and billing
  • Completes assigned work queues and handles daily incoming correspondence.
  • Participates in mandatory annual events and education sessions.