Patient Acct RepFacility: CHS Services Inc Location: Melville, NY Department: Managed Care Variance Category: Administrative / Business Support Schedule: Full Time Shift: Day shift Hours: 8am-4pm ReqNum: 6020192
Catholic Health Services of Long Island (CHS) is an integrated health care delivery system with some of the region's finest health and human services agencies. CHS includes six hospitals, three skilled nursing facilities, a regional home nursing service, hospice and a multiservice, community-based agency for persons with special needs. Under the sponsorship of the Diocese of Rockville Centre, CHS serves hundreds of thousands of Long Islanders each year, providing care that extends from the beginning of life to helping people live their final years in comfort, grace and dignity.
Under the direction of the Supervisor, the Patient Account Representative is responsible for accurate and timely hospital billing, follow up, collections, cash processing and customer service related activities.
- Reviews, corrects and approves all primary and secondary billing, submits hard copy or electronic claims to appropriate payors.
- Reviews and edits any rejections stemming from electronic billing submissions and corrects and resubmits claims, as required.
- Verifies accuracy of patient insurance and demographic information.
- Generates bills to patients for services not covered by insurance.
- Investigates duplicate payments and takes appropriate action to resolve. Initiates refund requests, where necessary, in accordance with departmental procedures.
- Perform follow up on all outstanding accounts assigned in accordance with established standards and procedures.
- Follows up on payer payment variances. Applies managed care contract rules to determine payment accuracy. Reports trends of payer behavior.
- Determines reason for denial and appeals accounts as necessary.
- Responds to all requests for information and telephone inquiries from patient, insurance carrier, physician office and outside agencies in a courteous manner.
- Cross trained in all phases of third party billing, follow-up, cash, credit and collections and customer service related activities.
- Establishes and demonstrates competency in accounts receivable systems and associated applications.
- High School diploma or equivalent required. Medical trade school preferred.
- One year of healthcare experience desired. Requires three to six months on-the-job training to become familiar with billing practices and policies.
- Ability to interpret third party coverage and institution's charges (rates) to patient.
- Ability to communicate effectively with others.
- Ability to comply with procedural guidelines and instructions and to solicit assistance when situations arise that deviate from the norm.
- Demonstrated competency operating a personal computer required.
- Required to sit for long periods of time interspersed with standing, walking and bending.
- Excellent verbal and auditory skills are required for communicating with internal staff, customers and representatives from external departments and agencies.
At Catholic Health Services of Long Island your well-being comes first, with comprehensive compensation and benefits; our offerings go beyond the basics. In addition to multiple medical plans, life insurance, generous paid time off and flexible spending accounts, we also offer substantial tuition reimbursement, an employer funded pension plan and several savings plan options for your future.