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3rd Party Account RepresentativeJob ID 147341 Date posted 06/30/2018
Position Summary: Responsible for the coordination of collection activity and rebilling for specific patient receivables, ensuring timely claims submission and resolution of all patients? accounts in the assigned receivable.
Essential Duties & Responsibilities including but not limited to:
1) Responsible for the timely submission and payment of claims.
2) Follows up on delinquent third party claims until they are paid, denied or written off.
3) Interacts by telephone and/or mail with third party carriers, provider representatives and patients relative to claims processing.
4) Processes and resubmits claims when necessary, utilizing a variety of EDI technologies and relevant billing systems.
5) Completes account receivables report. Reviews, troubleshoots and resolved assigned aged accounts receivable reports.
6) Reviews, troubleshoots, and remedies credit balance report and requests approval for refunds when appropriate.
7) Completes contractual adjustment report and posts adjustments to patient accounts as appropriate.
8) Reviews and determines whether denied claims were properly adjudicated and performs appropriate follow-up action.
9) Sorts, prepares and processes incoming insurance correspondence.
10) Maintains detailed documentation on individual account activity such as correspondence, phone conversations, and the like.
11) Responds to third-party inquiries and reports.
12) Identifies internal billing problems and notifies Supervisor and/or Manager.
13) Alerts Supervisor and/or Manager to procedural and/or system changes based upon third-party billing requirements.
Education: High School Diploma or equivalent.
Licensure, Certification, Registration: None required.
Skills, Knowledge & Abilities:
- Thoroughly proficient in data entry using a pc and a variety of electronic systems.
- Working knowledge of payer remittance documents, reject codes, ICD-9 and HCPC coding modifiers, and 3rd Party payer requirements.
- Possesses the ability and facility to work with electronic calculators and reconcile totals.
- Demonstrates attention to detail.
- Ability to troubleshooting and remedy detailed documents.
- Demonstrates excellent organizational skills.
- Demonstrates proficiency in the use of a variety of pc skills including word processing and spreadsheets.
Experience: Minimum 1 year experience in hospital billing and/or related activities.
About Lahey Health
The Lahey Model of Care - right care, right time, right place - is exactly what patients, providers and payers need and deserve. Identifying and delivering on this convergence of interests has positioned Lahey Health for further growth. Our model ensures care is highly coordinated and locally delivered, with lower costs and exceptional quality.
Lahey Health is a robust, regional system including a teaching hospital, community hospitals, primary care providers, specialists, behavioral and home health services, skilled nursing and rehabilitation facilities, and senior care resources throughout northeastern Massachusetts and southern New Hampshire. The system has a global presence with programs in Canada, Jordan and Bermuda.
How To Apply
Please apply directly online at http://www.laheyhealth.org/engage-with-us/careers. Use the Job ID number to quickly locate the appropriate job listing. Once you have located the desired job, click on the checkbox in the 'Select' column, and then click the 'Apply Now' button, located at the bottom of the screen. Please note you are only able to select 5 jobs at a time.
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