REP PATIENT SERVICES NM
Department:
Patient Financial Services - UH FTE:
1.
00 Full Time Shift:
Days Position
Summary:
Responsible for all patient accounts receivable functions as assignedReconcile, research, correct and submit third party claims and resubmit errors or denied claimsCommunicate with insurance companies and government payers to resolve claim issues and ensure paymentResearch and correct ICD 9, CPT coding, modifiers, revenue coding, occurrence codes and value codes as appropriateCollaborate with the Income Support Division and the Medical Assistance Division in regards to eligibility for MedicaidInterview and approve patients for UNMH charity programsProvide customer service to patients by researching billing issues with various departments and resolving the issuesReconcile remittance advices and patient accounts and resolve discrepanciesEnsure adherence to Hospital sand departmental policies and proceduresNo patient care assignmentDetailed
Responsibilities:
o CLAIMS - Reconcile, review, research, coordinate and justify changes to claim forms and submit completed claim forms to third party payerso CLAIMS - Reconcile and review remittances; research as necessary to determine proper accounts; research and obtain correct information; complete remittance processo DENIALS - Follow up on claims denials; contact appropriate party to research, coordinate and justify needed information; make appropriate corrections, obtain approvals and resubmit claims denials for payments; appeal denials through the payer required appeals processo FINANCIAL ASSISTANCE - Interview patients and complete the application process for State/Government programs; maintain MOSAA certification with the State; interview and approve patients for UNM Hospital charity and discount programso COLLECTIONS - Follow up on the collection of patient accounts, contact appropriate party (third party payers, other hospitals, patients) to obtain needed information; make appropriate corrections; obtain approvals and resubmit claim for paymento CLAIMS - Research unpaid claims; contact patients to obtain necessary information to assist with claims process; secure payments or negotiate payment planso CASH - Reconcile and complete cash reconciliation reports; balance and post payments, contractual allowances, and denialso CREDIT - Research, resolve and reconcile credit balances to include processing the refund request or take back with a payero COORDINATION - Work with various University Hospital departments to obtain additional information regarding services rendered to include correct coding and documentationo TRAINING - Perform training with registration and admitting personnel to assure proper registration and knowledge of business practices to include financial assistance programso COMMUNICATION - Handle patient inquiries, complaints and customer service issues by phone, in person or via the email; research and resolve the issueo DATA - Perform data entry and research using various hospital system programso PATIENT ACCOUNTING - Maintain current knowledge of regulations for Third Party Payers, Medicare, Medicaid and knowledge of claims coding and formatso DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshopso CUSTOMER RELATIONS - Establish and maintain good rapport and effective working relationships with patients, visitors, physicians and Hospitals employees
Qualifications Education:
Essential:
o High School or GED Equivalent
Experience:
Essential:
2 years directly related experience Nonessential:
Bilingual English, Spanish, Keres, Tewa, Tiwa, Towa, Zuni, Vaietnamese, or Navajo Credentials:
Essential:
o Not Applicable/Not Required Physical Conditions:
Sedentary Work:
Exerting up to 10 pounds of force occasionally (Occasionally:
activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently:
activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human bodySedentary work involves sitting most of the time, but may involve walking or standing for brief periods of timeJobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are metWorking conditions:
Essential:
o No or min hazard, physical risk, office environment Department:
Administrative Services Clerical Recommended Skills Accounts Receivable Billing Business Ethics Claim Processing Customer Relationship Management Customer Service Apply to this job.
Think you're the perfect candidate? Apply on company site Estimated Salary: $20 to $28 per hour based on qualifications.
Patient Financial Services - UH FTE:
1.
00 Full Time Shift:
Days Position
Summary:
Responsible for all patient accounts receivable functions as assignedReconcile, research, correct and submit third party claims and resubmit errors or denied claimsCommunicate with insurance companies and government payers to resolve claim issues and ensure paymentResearch and correct ICD 9, CPT coding, modifiers, revenue coding, occurrence codes and value codes as appropriateCollaborate with the Income Support Division and the Medical Assistance Division in regards to eligibility for MedicaidInterview and approve patients for UNMH charity programsProvide customer service to patients by researching billing issues with various departments and resolving the issuesReconcile remittance advices and patient accounts and resolve discrepanciesEnsure adherence to Hospital sand departmental policies and proceduresNo patient care assignmentDetailed
Responsibilities:
o CLAIMS - Reconcile, review, research, coordinate and justify changes to claim forms and submit completed claim forms to third party payerso CLAIMS - Reconcile and review remittances; research as necessary to determine proper accounts; research and obtain correct information; complete remittance processo DENIALS - Follow up on claims denials; contact appropriate party to research, coordinate and justify needed information; make appropriate corrections, obtain approvals and resubmit claims denials for payments; appeal denials through the payer required appeals processo FINANCIAL ASSISTANCE - Interview patients and complete the application process for State/Government programs; maintain MOSAA certification with the State; interview and approve patients for UNM Hospital charity and discount programso COLLECTIONS - Follow up on the collection of patient accounts, contact appropriate party (third party payers, other hospitals, patients) to obtain needed information; make appropriate corrections; obtain approvals and resubmit claim for paymento CLAIMS - Research unpaid claims; contact patients to obtain necessary information to assist with claims process; secure payments or negotiate payment planso CASH - Reconcile and complete cash reconciliation reports; balance and post payments, contractual allowances, and denialso CREDIT - Research, resolve and reconcile credit balances to include processing the refund request or take back with a payero COORDINATION - Work with various University Hospital departments to obtain additional information regarding services rendered to include correct coding and documentationo TRAINING - Perform training with registration and admitting personnel to assure proper registration and knowledge of business practices to include financial assistance programso COMMUNICATION - Handle patient inquiries, complaints and customer service issues by phone, in person or via the email; research and resolve the issueo DATA - Perform data entry and research using various hospital system programso PATIENT ACCOUNTING - Maintain current knowledge of regulations for Third Party Payers, Medicare, Medicaid and knowledge of claims coding and formatso DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshopso CUSTOMER RELATIONS - Establish and maintain good rapport and effective working relationships with patients, visitors, physicians and Hospitals employees
Qualifications Education:
Essential:
o High School or GED Equivalent
Experience:
Essential:
2 years directly related experience Nonessential:
Bilingual English, Spanish, Keres, Tewa, Tiwa, Towa, Zuni, Vaietnamese, or Navajo Credentials:
Essential:
o Not Applicable/Not Required Physical Conditions:
Sedentary Work:
Exerting up to 10 pounds of force occasionally (Occasionally:
activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently:
activity or condition exists from 1/3 to 2/3 of the time) to lift, carry, push, pull, or otherwise move objects, including the human bodySedentary work involves sitting most of the time, but may involve walking or standing for brief periods of timeJobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are metWorking conditions:
Essential:
o No or min hazard, physical risk, office environment Department:
Administrative Services Clerical Recommended Skills Accounts Receivable Billing Business Ethics Claim Processing Customer Relationship Management Customer Service Apply to this job.
Think you're the perfect candidate? Apply on company site Estimated Salary: $20 to $28 per hour based on qualifications.
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