73518BRJob Posting Title:Patient Accounts Representative (Remote)Department:Finance-Government PayorsAutoReqId:73518BRStatus:Full-TimeStandard Hours per Week:40 Job Posting Category:FinanceJob Posting Description:In accordance with government regulations and hospital policies, provides positive and effective customer service that supports departmental, foundation and hospital operations Manages daily assignments using standardized protocols and work drivers. Ensures required demographic, insurance, referral/authorization and clinical, data is collected, verified, and communicated appropriately. Coordinates activities with specific physician offices, service sites and ancillary departments. Prepares and submits accurate insurance claims to payer within proper timeframes. Works payer scrubber and denial reports in an effective and timely manner. Ensures prompt resolution of outstanding insurance claims. Identifies trends, denials, issues impacting account resolution or workload and refers as appropriate. Maintains a basic understanding of 3rd party payer contracts.

　　The Patient Accounts Representative will :

　　Collect, verify, and record all demographic information required for financial pre-processing of patients.

　　Verify insurance eligibility utilizing available technologies, payer websites, or by phone contact with third-party payers

　　Ensure that the correct insurance company name, address, plan, and filing order are recorded in the patient accounting system

　　Utilize payer exception reports to update coverage / PCP information

　　Contact clinical departments and PCP offices to secure referrals and enter into the patient accounting system

　　Document all actions taken on account with clear and concise account notes

　　Participate in process improvement opportunities

　　Billing and Collection:

　　Prepare and submit accurate insurance claims to the payer within proper timeframes. Accept, reject, and reconcile claim runs daily. Ensure prompt resolution of outstanding insurance claims

　　Effectively works payer scrubber and denial reports daily

　　Review claims for accuracy and correct errors as needed

　　Collaborate with referral/authorization staff to resolve issues

　　Update demographic and coverage information as needed

　　Resolve claims processing issues with 3rd party payers and provides all requested information timely; engaging patients and family members to resolve claim or insurance issues when needed

　　Provide documentation to have claims processed and paid. Research, prepare, and provide 3rd party payer appeals. Request account adjustments in accordance with payer contractual agreements

　　Document all actions taken on account with clear and concise account notes and maintains billing logs as required

　　Prepare reports as required. Monitor and identify trends, denial / claim errors by payer and refer as appropriate

　　Maintain a thorough understanding of 3rd party payer contracts

　　To qualify, you must have:

　　A high school diploma

　　Previous experience in a medical billing setting, preferably on an automated system is preferred

　　The ability to exchange information on factual matters. Interaction requires courtesy and tact when dealing with patients, hospital employees and third parties

　　Fluency in oral and written English, with emphasis on communication skills and ability to document records

　　The ability to work with diverse internal and external constituencies

　　Excellent attention to detail, good organizational skills, ability to meet priorities within set timeframes, and ability to work as part of a team

　　Boston Children’s Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

　　Office/Site Location:BostonRegular, Temporary, Per Diem:Regular Remote Eligibility :Part Remote/Hybrid