Together, The Opportunities Ahead Are Unlimited
The Patient Account Representative will be responsible for all aspects of billing, follow up and collection activity.
The Specialist Case Manager RN, under the direction of the Supervisor or Manager of Case Management provides direction, identifies health and psychosocial issues of a select member population and assesses, plans, implements, coordinates monitors and evaluates services and outcomes to ensure maximized health of the member. Assumes a leadership role within the interdisciplinary care team to achieve optimal clinical and resource outcomes.
This position will improve the automation of existing financial reporting for our at-risk provider clients and enable our department to quickly tailor client reporting packages based on their business lines. This position will also support ad hoc financial reports requested by our clients.This position uses advanced knowledge of business intelligence and analytical tools to summarize data in a meaningful and presentable format. Utilizes technical skills to schedule reports and to produce user requested data templates/reports for user self-service reporting. Validates newly developed reports/processes against detail level data during the development cycle. Provides written and/or verbal analysis of data to customers.
Responsible for duties in support of departmental efficiencies which may include but not limited to performing scheduling, registration, patient pre-admission and admission, reception and discharge functions. Must obtain complete and accurate patient demographic information. Patient Access representatives also must employ proper, compliant patient liability collection techniques before, during and after date of service.
Support and provide coding and compliance training to physicians, clinical personnel, billing, and/or other client staff. Establish effective communication with physicians, clinical staff, and/or hospital staff to address documentation, coding, and reimbursement issues. Use knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues. Participate in special audits and system administration as necessary.
Works across multiple sites to provide direction to the Quality Control team while monitoring daily workflows, auditor assignments and production, and ensuring compliance with health plan and regulatory requirements. This position is also responsible for maintaining an engaged and productive staff by coaching, motivating, providing support, direction and developing employees to maximize their full potential.
Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.