ACCOUNT REPRESENTATIVE

Position Summary:
Under the general supervision of the Business Office Manager, the Account Representative is responsible for the billing, collection, and reconciliation of accounts, and educating related departments about the billing/collection/reconciliation processes to ensure that clean, collectible claims are sent to payers in a timely manner.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all inclusive.

Essential Duties & Responsibilities:
•    Review patient’s accounts to determine the status of the account.
•    Make standard adjustments. 
•    Prepare and process a variety of documents necessary for the maintenance and follow-up of all outstanding patient’s accounts.
•    Examine accounts for accuracy, adequate documentation, and compliance with regulations. 
•    Telephone third party payers regarding amounts that are due. 
•    Perform follow-up procedures in a timely manner in accordance with hospital Business Office policy and procedures. 
•    Generate contractual adjustment documents, when appropriate.  
•    Identify accounts that are deemed non-collectible and make appropriate adjustments. 
•    Report any discrepancies to the Dental Director providing all supporting documents and recommending resolution. 
•    Generate monthly reports and close month by the first week of the following month and submit to the Finance Department.  
•    Help with Dental Receptionists, as needed.
•    Perform other duties as assigned.

Minimum Qualifications:
•    High School Diploma or General Equivalency Diploma. 
•    Diploma or certification in Medical Billing and Coding preferred. 
•    Two (2) years of experience working with Medicare, AHCCCS or Commercial billing in a healthcare setting.
•    Must be able to successfully pass the Employee Health Screening requirements and background investigation. 
    
Knowledge, Abilities, Skills, and Certifications:
•    Knowledge of Medical and Dental Terminology.
•    Knowledge of ICD-9, CDT coding and ICD-10.  
•    Ability to organize and keep records/files, MS Office Programs.
•    Knowledge and understanding of Third-Party reimbursement/claims processing and follow up processes.
•    Knowledge of the Meditech computer system, Dentrix dental software, and MS Office.
•    Ability to read and understand aging reports and use them to target accounts for concentrated collection efforts.
•    Ability to exchange ideas and information in a timely, concise, effective, and interpersonally appropriate manner.
•    Demonstrate action and behavior that contribute to creating an environment where all individuals are treated in accordance with the mission & value statement. 
•    Ability to model Sage Memorial Hospital mission, values, and ethical standards and to perform work responsibilities in an effective, timely and efficient manner. 
•    Ability to understand departmental and organizational goals and to effectively prioritize and perform work responsibilities in a manner which best achieves those goals.
•    Knowledge of the Joint Commission, HIPAA, Federal State and Local regulations including Workers Compensation and OSHA regulations. 
•    Ability to perform tasks without constant supervision, the delivery of assigned work on a timely basis, and follow-up of all assignments, on a timely basis. 
•    Ability to ensure neatness, completeness, thoroughness and organization of work and work habits. This work must be completed without errors or omission. 
•    Ability to speak the Navajo language and/or a familiarity with the Navajo Way.
    
Physical Demands:
While performing the duties of this job, the employee regularly is required to sit; use hands to reach and grasp objects; reach with hands and arms; and talk or hear. The employee frequently is required to walk. The employee occasionally is required to stand; and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 50 pounds.
    
Work Environment:
The employee will work in a Patient Care/Office Environment with moderate noise level. Normal scheduled hours are four, 10-hour shifts: Monday – Thursday or Tuesday – Friday.