Patient Account Representative III

At Medusind Inc., we take immense pride in offering superior, cost-effective solutions covering the whole spectrum of tasks and processes to the healthcare industry. A significant factor is that our workforce comes with rich domain expertise and robust compliance norms.
Our four-prong approach of an excellent management team coupled with a detailed eye for processes experienced manpower, and cutting-edge technology helps us deliver superior, cost-effective services to our clients across the globe.
Benefits:

• Health insurance.
• Dental insurance.
• Vision insurance.
• 401(k).
• Employer-paid life insurance.
• Employer paid short-term and long-term disability.
• Voluntary additional life insurance.
• Employee Assistance Program.
• 48 hours of sick time after three months.
• 80 hours of vacation time after six months which continues to grow based on the number of years of service.
• $400 referral bonuses.

The Patient Account Representative III is responsible for providing high quality billing services to our clients. The Patient Account Representative will recognize potential high-risk issues and develop techniques to help collect money and streamline processes. The team member will discuss difficult or unique problems with the Revenue Cycle Manager, resolve issues, apply new information to future collection issues, and make suggestions to enhance our efficiency and effectiveness through process improvement with the assistance of their immediate supervisor. This position will enhance the revenue reimbursement department's reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.

In this role, you'll be collaborating with an innovative team of people moving exciting projects forward and working to improve systems and processes along the way for various types of specialties including FQHC, CHC, Behavioral health, Dental, etc.

Duties and Responsibilities:

• Proficient in FQHC/CHC/RHC billing
• Knowledge of Health care third party reimbursement programs, such as Medicare, Medi-Cal, Managed Care Health Plans, or private insurance
• Knowledge of the methods and practices of billing, accounts receivable, and collection.
• Ability to interpret billing policies and procedures for various programs.
• Ability to independently carry out varied billing assignments.
• Excellent communication skills; must be able to work in a team environment.
• Demonstrates effective communication and problem-solving skills.
• Demonstrates competency in proper (Current Procedural Terminology) coding guidelines, proper use of modifiers, payer specific billing guidelines, Correct Coding Initiatives, etc.
• Demonstrates ability to proof and post batch entries daily.
• Demonstrates working knowledge in processing and preparation of Payor, Special Program
• Work with the Medical Billers to make sure all information on claims is correct prior to submission.
• Audit claims for accuracy and compliance with program billing requirements.
• Understand reimbursement arrangements and is able to follow up with payors to assure that all claims are paid.
• Work to reduce Account Receivable by improving accuracy of claims and reducing claim denials.
• Demonstrate the ability to Identify trends and provide solution.
• Must process required number of claims.
• Additional duties as assigned.

3 years EPIC OCHIN experience with practice management system. Demonstrate the ability to identify and resolve underlying issues related to outstanding revenue collections, including capturing lost opportunity. Follow clinic billing processes in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the health care system.

Education:

• High School Diploma (or GED or High School Equivalence Certificate)
• 3 plus years of full-time experience in all facets of FQHC/CHC billing within a multi-entity, healthcare environment.
• Preferred Certificate in Medical Billing and Coding.