Patient Account Rep-Biller

1. .  Reviews and files insurance claims in a timely manner.  Has a vast knowledge of Medicare and Medicaid rules and regulations as this will be the primary focus for this position.  Has vast knowledge of Critical Access Hospital rules and regulations for Medicare fiscal year end closing process and experience with DDE system within Medicare for access with eligibility, claims and submission status.

2. Follows up with secondary claims timely and keeps log of all Medicare cross over and bad debt logs for cost reports.  Knowledge of PS&R and HS&R reports.

3. Has knowledge of self-pay accounts and after insurance accounts to assist with these accounts when needed.

4. Demonstrates competency in all required Business Office Procedures.

5. Has vast knowledge of payment deposits, deductibles, indigent care information and/or payment plan arrangements upon discharge for inpatients.

Qualifications:

1. High School Diploma or GED required.
2. 3 years related experience and/or training.
3. Or equivalent combination of education and experience
4. At least 3-year experience in medical claim filing and vast knowledge of Medicare and Medicaid guidelines for Critical Access Hospitals.
5. Basic typing skills, proper phone etiquette and computer software and electronic claims input.

6.     Ability to read and comprehend simple instructions, short correspondence and memos.

7.     Experience using the DDE (Direct Data Entry) application for Medicare claims, submissions and status on billing.

8.     Ability to effectively present information in one-on-one and small group situation to customers, clients, and other employees of the organization.