Patient Accounts Representative I/ Appeals and Denials
The position requires an experienced collector that understands AR follow up. The collector should have knowledge of how to appeal a denied claim and check status of a claim by payer website or placing a telephone call to the payer.The collector will help to expedite and maximize the payment of insurance medical claims by contacting third party payers and patients. The collector will call insurance companies or access the payer website for claim status, appeal status on denied claims and payment reimbursement.
- Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients.
- Identifies patients accurately and assigns the patient a unique identification number.
- Secures patient accounts in order to maximize reimbursements in a customer service oriented fashion.
- Maximizes the efficiency and accuracy of the collection process by up-front collection and maintaining bill hold reports.
- Provides documentation in the patient’s charts of general consent, information release, advanced care directives, and other requirements.
- Contacts third party payers and patients to determine the reason for non-payments or delays in payments of medical claims.
- Corrects claims and re-files.
- Assists with inquiries from outside parties regarding account status.
- Drafts letters to the insurance company’s Medical Review Board to expedite payment.
- Evaluates if payments were made according to contract.
- Researches and appeals insurance denials.
- High school diploma or GED.
- One year of relevant experience.
- Patient Account or Coding certification.
- Experience with accessing the payer website for claim information.
- Experience in submitting an appeal for reimbursement.
Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.