Lower Umpqua Hospital seeks a Full-time Patient Account Representative III. The PAR III is responsible for processing all assigned patient accounts from initial billing to collection of all amounts due from each of the patient’s insurance carriers.
Under the general direction and supervision of the Patient Financial Services Director, and in accordance with established departmental and Health System policies, procedures, and standards, performs duties as assigned including, but not limited to, the following:
- Reviews registration forms for Medicare inpatients to ensure the accuracy of data.
- Reviews online claim forms to ensure completeness and accuracy of data; makes adjustments to the claim as necessary. Submits UB-92 claim forms in a timely manner to insurance carriers for payment manually or electronically, with proper documentation.
- Conducts follow-up on outstanding insurance accounts. Investigates problem accounts to determine the reason for non-receipt of payments, and follows up with insurance carrier.
- Reviews patient statements for proper message and accuracy of balances prior to mailing. Bills patients for their cost-share after all insurance carriers have made payment.
- Responds to phone calls and inquiries from patients, insurance carriers, and physicians regarding patient accounts. Reviews concerns with patients.
- Verifies insurance payments to ensure correct amounts are received. Calculates appropriate adjustment amount, if applicable, and prepares adjustment form.
- Evaluates accounts for collectability; prepares adjustment forms to write off uncollectible accounts.
- Reviews accounts with credit balances to verify the credit balance, and takes appropriate action, e.g., prepare an adjustment, or submits account for refund processing.
- Assists in training and orientation of new staff in software applications and Premis as required.
- Maintains confidentiality of employee, patient, and Health System information.
- Attends meetings and all mandatory in-services as required or requested.
- Maintains Health System core values of quality, caring, ownership, pride, teamwork, respect, and responsibility.
- Sends insurance information inquiries and group insurance forms to patients for completion; follows up on forms not returned.
- Rotates with other staff to perform interfacing/download/transmission for Premis and Care Medic systems.
- Participates in performance improvement activities of the department.
- Performs other duties as assigned by the Patient Financial Services Director.
Competitive Wage and Benefits offered. Must clear criminal background check and pre-hire drug screen (including marijuana).