Job Description

Position Overview

We are seeking a dedicated and detail-oriented Patient Account Representative II to join our dynamic team. If you possess a solid understanding of Revenue Cycle Management processes and have experience in handling denials and appeals, we would be excited to hear from you!

Key Responsibilities

Analyze denied claims to determine the most effective course of action for appeals or resubmissions.
Prepare and submit accurate and compliant appeals for denied claims, ensuring adherence to all guidelines.
Collaborate with billing, coding, and clinical staff to gather the necessary information for appeals and resolve denial issues efficiently.
Maintain meticulous records of denial cases, including appeals filed and communications with insurance representatives.
Monitor the status of appealed claims and proactively follow up with insurance representatives to expedite resolutions.
Generate and analyze reports on denial trends, identify root causes, and recommend process improvements to enhance overall efficiency.
Qualifications

Education, Licensure, Certifications, & Experience:

High school diploma or equivalent.
A minimum of 2 years of current experience in claims processing and denials management.
At least 1 year of recent experience with the EPIC EMR system.
Skills:

Strong analytical skills to evaluate denial reasons, identify trends, and develop strategies for minimizing future denials.
Excellent written and verbal communication skills to foster effective communication with internal staff and insurance representatives.
Meticulous attention to detail and accuracy in documentation and appeals submissions.
Ability to collaborate effectively with multidisciplinary teams to achieve shared goals.
Thorough understanding of billing regulations, coverage guidelines, and the appeals process.
Physical Requirements

Sitting: 90% of the time
Standing/Walking: 10% of the time
Occasional lifting and carrying of supplies and paper weighing up to 40 pounds.
Occasional pushing or pulling to move supplies and equipment.
Occasionally climbing stairs to access different levels of the building.
Occasionally stooping, kneeling, bending, or crouching to file in low cabinets, purge old bills, and print forms.
Occasional reaching, handling, or fingering to complete paperwork, use computers, file, and answer telephones.
Frequent talking, hearing, and seeing to interact with staff and customers to complete assigned tasks.
Environmental Conditions

Work is primarily performed indoors, with options for onsite or remote arrangements.
Employment Type: Full-Time
Salary: $ 41,600.00 52,000.00 Per Year

Job Tags

Full time,

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