Patient Account Representative
Primary Location Wailuku, Hawaii
Worker Location Remote
Job Number 1278613 Date posted 05/09/2024
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Description:
Essential Responsibilities:
Job Summary:
Patient Account Representatives perform billing and follow up for hospital or professional claims. This includes accurate and timely submission of claims and insurance follow up, according to State & Federal regulation and payer guidelines. Also resolves denials and does reimbursement analysis to ensure maximum reimbursement was received according to payer contractual agreements.
Essential Responsibilities:
- Performs accurate and timely billing of insurance claims in accordance with policies and procedures of Maui Health and in compliance with State/Federal regulations, payer health plan guidelines, and third-party payer requirements.
- Expedites larger dollar accounts to ensure revenue optimization for prompt payment.
- Follows up timely on payment with insurance companies, agencies, payers and/or patients; researches and takes action as required on outstanding accounts.
- Audit payments and appeals (as needed) to ensure Maui Health has received corrected, expected payment from payers in accordance with contract terms.
- Responds to patient and insurance inquiries promptly and courteously.
- Performs audits as needed for quality control and to ensure efficient follow up.
- Collects monies owing for all services rendered, including third party payers, employers, and guarantors.
- Document all actions into account notes.
- Resolves payer denials, including submission of appeals as needed.
- Communicates timely and appropriately with Team Lead/Supervisor to identify and resolve payer/claim submission issues.
- Analyzes and takes appropriate action steps according to MHS protocols.
- Strives to achieve targeted benchmarks and exceed collection goals for prompt account resolution.
Basic Qualifications:
Experience
- Minimum one (1) year collections or administrative experience.
Education
- High school diploma.
License, Certification, Registration
- N/A
Additional Requirements:
- Demonstrated ability to perform diversified clerical functions and basic accounting procedures.
- Demonstrated ability to motivate debtors to pay.
- Demonstrated knowledge of and skill in adaptability, change management, conflict resolution, customer service, influence, interpersonal relations, oral communication, problem solving, teamwork, and written communication.
Preferred Qualifications:
- Minimum one (1) year experience medical insurance claims processing, demonstrating knowledge of Medicaid, Medicare, & Commercial payer requirements.
- Post high school coursework in accounting.
- An Associates Degree or Bachelors Degree in Business Administration, Finance, Accounting or Healthcare-related field may be substituted for one (1) year experience as a Patient Account Representative.
- Knowledge of medical terminology, CPT-4 and ICD-10-CM coding.
- 10-key by touch.
Primary Location: Hawaii,Wailuku,Maui Mem. Wili Pa Loop Building
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 08:00 AM
Working Hours End: 04:30 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Remote
Employee Status: Regular
Employee Group/Union Affiliation: S03|AFSCME|UNAC-UHCP-UNHCEH
Job Level: Individual Contributor
Department: WILI PA - Pat. Financial Ops & Admin - 3601
Pay Range: $21.38 - $22.58 / hour
The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted.
Travel: No
Remote: Work location is the remote workplace (from home) within KP authorized states.
Worker location must align with Kaiser Permanente's Authorized States policy.
At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. Submit Interest
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. Submit Interest
