NEW JOB OPENING
PATIENT ACCOUNTING REPRESENTATIVE
IN Wailuku, HI, USA!

• Required Level of Education: High School



• Preferred Level of Education: Certified Medical Biller or Associates Degree in related field.



• How many years of related experience are you looking for in your ideal candidate?: 1 year



• Top Three things Worker will be doing: Insurance Collector and Denials, sending insurance requested information, reporting Insurance trends



• Top Three Skillsets needed: Critical Thinker, Multi-tasker, Teachable



• Specific Systems Knowledge Required: Outlook, Microsoft Office



• Specific Systems Knowledge Preferred: Epic and Change Health Care



• Any Required Certifications?: No



• Expected Shift: Mon – Fri 7:30 am – 4:00 pm



• Office Location (if remote, please provide the Client Site address): Wailuku HI



• Any Travel for this role?: No



• Interview Process: Panel Inteview







• Anything else important we need to know to fill your role?: Experience in this related field would be choice.





Patient Accounting Representative Job Summary



• Under indirect supervision, processes insurance claims, reports and billing for compensation of patients and members for medical disability benefits;

• processes applications from medical/life insurance, supplemental benefits and assigned accounts;

• obtains background information;

• makes arrangements to obtain monies owing;

• performs other collection responsibilities as needed;

• abides by state collection and credit regulations;

• interprets and complies with state/federal regulations, laws and guidelines in reference to third party payers;

• processes VRs for billing; maintains current knowledge of Client Health Plan benefits and policies;

• acts as Client representative.





Major Responsibilities/Essential Functions,



• Receives, reviews, and controls requests for medical information, visit records, nurse/doctor notes and other pertinent documents;

• verifies completeness and accuracy;

• ensures efficiency in processing of claims;

• obtains medical charts and other data pertaining to request.

• Audits, abstracts, and summarizes pertinent data from patient medical records, nurse/doctor notes and other documents;

• processes insurance claims and reports in compliance with state/federal regulations, laws, guidelines and Client Health Plan policies;

• obtains physician signature and/or signs as provider representative; prepares service charge letters and invoices referring to fee schedule.

• Performs follow-up with insurance companies, agencies, and/or patients; researches and takes action as required.

Prepares and audits visit records and nurse/doctor notes using various fee schedules; prepares documents (e.g. charges, payments, adjustments) with Charge Description Master codes, required billing coding conventions, and batch totals.

• Communicates and corresponds effectively with insurance carriers, intermediaries, members, doctors, outside providers and patients;

• provides in-service orientation to other departments/personnel; obtains complete and valid information;

• ensures collectability and maximum reimbursement of revenues.

• Maintains familiarity and open communication with state, federal and community agencies

• **Only those lawfully authorized to work in the designated country associated with the position will be considered.**

• **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**