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Account Representative

Harlingen Medical Center Harlingen Full-Time
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Overview

JOB SUMMARY: The Account Representative is responsible for posting all incoming payments to correct patient accounts on a daily basis. Inputs and retrieves data from computer systems. Reconciles accounts daily. Applies payments to patient accounts accurately and efficiently. Distribution of all billing to appropriate personnel. Reviews and performs follow-up on all authorizations, and specialty referrals. Maintains a current knowledge of contracts and state Worker’s Compensation fee schedules. Responsible for the handling of incoming and outgoing mail pertaining to the hospital. Needs to have ability to recognize and correct mailing errors immediately. Always uses proper tact and discretion in handling inquiries from patients and their families. The Account Representative is responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement of Hospital’s receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate California and Federal regulations in order to assure compliance in payment practices. Responsible for posting all incoming payments to correct patient accounts on a daily basis. Inputs and retrieves data from computer systems. Reconciles accounts daily. Applies payments to patient accounts accurately and efficiently. Applies contractual adjustments to patient AR balances as needed. Manage and forward underpayments /denials to the appropriate departments for follow-up and further revenue collection as needed.

Responsibilities

B. DUTIES AND RESPONSIBILITIES1. Ability to communicate hospital deposit policies and payment arrangement standards 2. Accurately documents EOB/RA information in the Hospital Computer system. 3. Always uses accurate payer codes and financial classes. 4. Answer main business office line as needed and responds to the majority of requests or inquiries without forwarding the call to other business office personnel. 5. Applies all incoming receipts to correct patient accounts both accurately and expediently (uses appropriate payment codes). 6. Applies appropriately all denials/rejections codes timely and accurately 7. Balances mail receipts against bank statements 8. Calculates and completes contract adjustments accurately and in a timely manner. 9. Document all work performed in hospital patient accounting system. 10. Makes clear legible notes in Hospital Computer System pertaining to any work done on an account. 11. Performs all other duties as assigned or required. 12. Prepares the CTR report balances to the deposit. 13. Provides uncompliance weekly/monthly reports that are not meeting contractual agreements 14. Reconciliates receipts to ensure accuracy of daily posting. 15. Resolve all unidentified payments in accordance with corporate guidelines 16. Responsible for sorting all incoming mail. 17. Review and initiate timely resolution of overpayment, underpayments, and credit balances. 18. Review journals received from all Point of Service areas 19. Reviews all contract and non-contract payments for accuracy on a daily basis. 20. Reviews Contract Manager underpayment/overpayment variance reports; correct contractual adjustments when underpayment is received to reflect underpaid amount. 21. Reviews correspondence on a daily basis documenting into Patient Accounting system and scanning into hospital scanning system. 22. Scans remittance advises and other items as requested. 23. Updates patient accounts as needed with insurance information selecting the correct insurance payer code and demanding a claim. 24. Uses applicable write off codes when requesting an adjustment to a patient account. 25. Works closely with the accounting department to resolve any cash variances

Qualifications

EDUCATION, EXPERIENCE, TRAINING

1. Ability to multi-task, prioritize needs to meet required timelines2. Analytical, mathematical and problem-solving skills required3. Customer Services experience required4. Effective written and verbal communication skills5. Experience in accounts payable, accounts receivable or cashier experience preferred 6. Familiar with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred7. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)8. Knowledge of basic understanding medical coding and third-party operating procedures and practices9. Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience required10. Medical and Insurance terminology essential

We are an Equal Opportunity/Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics.  If you need special accommodation for the application process, please contact Human Resources.  EEO is the Law: http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf
 

Recommended skills

Billing
Accounts Receivable
Remittance
Collections
Receivables
Explanation Of Benefits (Eob)

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Account Representative
Estimated Salary: $88K
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Job ID: 2019-26059

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Welcome to the award winning Harlingen Medical Center a nationally
recognized leader in community healthcare delivery.
Harlingen Medical Center is a Level IV Trauma Designated hospital that
specializes in the areas of Bariatric (Surgical Weight Loss), Cardiology,
Critical Care / ICU, Emergency Room (Advanced Level IV) Trauma Center,
Gastroenterology, Internal Medicine, Nephrology, Neurology, Obstetric &
Gynecology, Operating Room (Surgical Services), Orthopedic, Pediatric,
Radiology / Imaging, Respiratory, Sleep Study, Speech Pathology, Thoracic
Surgery, Vascular & Endovascular Surgery, Wellness Screenings, and Wound
Healing.
Our concept of "Patient Focused Care" puts you, the patient,
first! The design, management, staffing, and operation of our hospital are
focused on your needs and overall comfort. Each caregiver is highly skilled and
cross-trained in various fields, thus providing you with high quality care,
always.
Harlingen Medical Center provides patient education through a
multidisciplinary team working to address all scopes of the health care needs
of patients.
Thank you for choosing Harlingen Medical Center to meet your healthcare needs!

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