Wailuku, Hawaii
Patient Accounting Representative Job Opening in Wailuku, Hawaii - Job Summary:
? Under indirect supervision, processes insurance claims, reports and billing for compensation of patients and members for medical disability benefits
? Processes applications from medical/life insurance, supplemental benefits and assigned accounts
? Obtains background information; makes arrangements to obtain monies owing; performs other collection responsibilities as needed; abides by state collection and credit regulations
? Interprets and complies with state/federal regulations, laws and guidelines in reference to third party payers
? Processes VRs for billing
Major Responsibilities:
? Receives, reviews, and controls requests for medical information, visit records, nurse/doctor notes and other pertinent documents; verifies completeness and accuracy
? Ensures efficiency in processing of claims
? Obtains medical charts and other data pertaining to request.
? Audits, abstracts, and summarizes pertinent data from patient medical records, nurse/doctor notes and other documents
? Processes insurance claims and reports in compliance with state/federal regulations, laws, guidelines and Health Plan policies
? Obtains physician signature and/or signs as provider representative
? Prepares service charge letters and invoices referring to fee schedule.
? Prepares and audits visit records and nurse/doctor notes using various fee schedules
? Prepares documents (e.g. charges, payments, adjustments) with Charge Description Master codes, required billing coding conventions, and batch totals.
? Communicates and corresponds effectively with insurance carriers, intermediaries, members, doctors, outside providers and patients
? Obtains complete and valid information; ensures collectability and maximum reimbursement of revenues.
? Performs other duties and accepts responsibility as assigned.
Minimum Education:
? High school diploma; or equivalent combination of education (lesser) & experience may be considered in lieu of requirements.
Basic Qualifications:
? One (1) year collections or medical insurance claims processing experience.
Preferred Experience:
? Knowledge of medical terminology, CPT-4 and ICD-9-CM coding.
? 10-key by touch.
? Demonstrated knowledge of and skill in word processing, spreadsheet, and database PC applications.
Category: IT code: new
? One (1) year collections or medical insurance claims processing experience.
? Demonstrated knowledge of and skill in word processing, spreadsheet, and database PC applications.
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