GWU Medical Faculty Associates
Position SummaryResponsible for the billing, collection, and resolution of patient account balances to include the development of action plans to resolve delinquent accounts and respond to complaints. Essential Duties and Responsibilities include the following. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
- Reviews and interprets payer remittances to determine appropriate action to be taken on denied claims. Based on basic proficiency in diagnosis coding (ICD-9) and procedural coding (CPT) may resubmit for coding correction.
- Contacts payers for status of unpaid claims. Maintains knowledge/understanding of third party payer regulations for managed care, Medicare, and Medicaid accounts.
- Resubmits claims to payer, if no record of receipt.
- Corrects and/or updates patient registration data. Reviews all invoices and makes necessary financial transfers.
- Analyzes outstanding account balances and determines plan of action to resolve.
- Appeals low payment claims to maximize reimbursement.
- Communicates payer trends or problems, identified as impacting reimbursement, to management team.
- Respond to billing inquires. Researches and effectively resolves issues through knowledge of medical billing practices. Documents actions taken and communicates results.
- Recommends account adjustments for bad debt write-off, contractual allowances, and discounts.
- Initiates collection calls to patients for outstanding balances.
- Generates collection letter and follows up on delinquent account balances. Maintains knowledge of consumer credit regulations for self-pay accounts.
- Makes payment plan arrangements for patients experiencing financial difficulty.
- Arranges settlement of accounts with attorneys and insurance companies.
- Organizes daily time to meet collection goals and productivity standards as defined by the management team.
- A High school degree is necessary.
- An Associate s degree in accounting, business or health care administration is desirable.
- A minimum of 3 years experience as a patient account representative, or an equivalent combination of experience and education, is necessary.
- Familiarity with computer terminal and current office equipment is necessary.
- Training or experience with coding and payer regulations is necessary.