Patient Accounts Representative

The Center for Family Health is a Federally Qualified Health Center located in Jackson Michigan.

Our mission is: Opening the Doors to Healthcare for All.

We provide primary healthcare and dental services regardless of an individual’s ability to pay.The Center for Family Health currently has a position open for a Patient Accounts Representative.

This is a full-time, non-exempt hourly position.Position Summary:Independently and accurately submit billable claims, maintain aged A/R, monitor and resolve credit balances, reconcile payment posting.

Essential Duties and Responsibilities:Insurance Posting:Technical ability to upload and download insurance payment and rejection information from Portals, Websites and auto post within Practice Management SystemInsure accurate entries of Insurance, Contractual and patient payment data in Practice Management systemWork with clearinghouse and payer to locate missing payments, checks, etc.Reconcile payer
– initiated take backsBalance and post to daily bank deposit within 24 hoursDocument daily payment activity using Excel spreadsheet, submit for reviewEnroll or update providers in clearinghouse portalReview patient and insurance credit balances and WQ’s for correct recipient of refund.Patient Account Representative:Possess excellent verbal, written and organization skillsVerify patient Demographics, Insurance coverage, etc., update or make appropriate changes Abide by CPT, CDT, ICD 10, HCPCS, Payer rules, regulations and guidelinesCorrect or obtain missing documentation needed to convert claims to a billable status, interact with clinical staff and Providers Maintain expertise on payer rules, and interacting with them to ensure account accuracy and payment within timely file limit Effectively follow up on claim status delays within established timelines to minimize uncollectible invoices.Ability to work within multiple Practice Management, Clearinghouse and Payor Portals, understand workflows Resolve patient billing questions, complaints; initiate appropriate follow up or adjustments.Consult with clients regarding available FQHC medical/dental assistance programs.

Credentialing:Complete initial and re-credentialing applications to insure payment for all servicesUpdate or maintain provider applications, contracts and update into shared databasePerform ongoing research to ensure correct data which does not interfere with provider reimbursementTrack contract application statusMeet required turnaround times and accuracy ratesRespond to all practitioner, client health plan and internal inquiries in a timely mannerFacilitate provider-related research on suspended claims or miscellaneous feedbackRemain organized, prioritize and make independent decisions with multiple interruptionsStrong attention to detailCoding and Auditing:Assist Facility and Department to ensure documentation is compliant and supports level of code(s) billed.

Able to perform E and other Outpatient documentation reviewsTrack and upload data to appropriate sourceEducation/Training/Experience:High School Diploma or equivalent.Minimum two years medical insurance billing with certification preferred.Job Knowledge, Skills & Abilities:Knowledge of CPT, ICD10, Medical and Dental codingExcellent written and verbal communication skills.Ability to work independently and make appropriate decisionsAbility to work with various software programsDemonstrates understanding and appreciation for diversity for CFH patients and CFH employees and the importance of good customer serviceThe Center for Family Health is an Equal Opportunity Employer.

All applicants have equal opportunities of employment irrespective of their race, color, religion, national origin, age, gender, gender identity, sexual orientation, marital status, physical or mental disability, genetic information, pregnancy, or protected veteran status, and any other legally protected class except when these factors constitute bona fide occupational qualifications.