Senior Account Representative DME and (Occ Health)

Position information

Title : Senior Account Representative DME and (Occ Health)

Facility : Fidelity Health Care

Job Reports to : Supervisor, Patient Accounting

Premier Health Mission, Vision, and Values

The Premier Health Mission

We will build healthier communities with others who share our commitment to provide high-quality, cost-competitive health care services.

The Premier Health Vision

Patients, physicians, and employees will choose Premier Health over any other health care provider in Southwestern Ohio. We will earn their choice, and grow our market leadership by anticipating their needs and exceeding their expectations.

§ Patients and their families will choose us for our quality outcomes and compassionate care at a competitive price.

§ Physicians will choose us as collaborative partners for our easy, efficient practice environment and with a shared passion for high-quality medical outcomes.

§ Our employees will choose us as a great place to work, learn and build a career.

The Premier Health Values

§ RESPECT each person’s dignity.

§ Act with INTEGRITY to do the right thing in all aspects of our responsibilities.

§ Serve with COMPASSION that embraces each individual’s concerns and hopes.

§ Commit to EXCELLENCE as measured to the highest level of performance.

Position Summary

General Summary/Responsibilities:

The Senior Account Representative is responsible for billing services/charges to the appropriate payer, as well as validation of receipt of electronic and hard copy claims. The incumbent must also review assigned accounts receivable as well as monitor trends, payment, etc. He/she must maintain good customer service with patient or payer and interface with office staff and perform other duties as assigned.

DIMENSIONS :

Responsible for billing assigned claims timely and appropriate follow up.

Scope/Span of Control: N/A

Supervisory Responsibilities (if applicable)

Supervises FTEs: No

Number of FTEs Supervised : N/A

Exercises full management authority including performance reviews, discipline, termination and personnel hiring No

Fiscal Responsibilities (if applicable)

Annual Revenue in Dollars : N/A

Annual Expense in Dollars : N/A

Financial Accountability : N/A

Population Served

Age of Population Served - Choose all that apply

☐ Infant (birth – less than 1 year)

☐ Pediatric/Adolescent (1 – less than 18 years)

☐ Adult (18 – 64 years)

☐ Geriatric (65 years & older)

☐ All Age Groups (Birth & Above)

☒ Not Applicable

Qualifications

Education

Minimum Level ofEducation Required:

High School completion / GED

Additional requirements:

§ Type of degree : N/A

§ Area of study or major : N/A

§ Preferred educational qualifications : N/A

§ Position specific testing requiremen t: N/A

Licensure/Certification/Registration

§ N/A

Experience

Minimum Level ofExperience Required:

No prior job-related work experience

Prior job title or occupationalexperience: N/A

Prior specific functionalresponsibilities: N/A

Preferred experience: Medical terminology, computer skills, and home health collection experience preferred.

Other experience requirements: N/A

Knowledge/Skills

§ 2-3 years’ experience in Medicare, Medicaid and third party billing procedures or equivalent is desired.

§ Must have good organization skills and work well with others.

§ Must be able to work independently.

Physical Requirements & WorkingConditions

PhysicalRequirements:

Pulling

2 - Occasionally (11% - 40%)

Standing

2 - Occasionally (11% - 40%)

Other sounds

1 - Rarely (0% - 10%)

Twisting

2 - Occasionally (11% - 40%)

Reaching

2 - Occasionally (11% - 40%)

Visual Acuity Near

3 - Frequently (41% - 75%)

Walking

2 - Occasionally (11% - 40%)

Manual Dexterity

2 - Occasionally (11% - 40%)

Visual Acuity Far

2 - Occasionally (11% - 40%)

Sitting

4 - Consistently (76% - 100%)

Use both hands

3 - Frequently (41% - 75%)

Vision Color

2 - Occasionally (11% - 40%)

Pushing

1 - Rarely (0% - 10%)

Talking

3 - Frequently (41% - 75%)

Concentrating

4 - Consistently (76% - 100%)

Climbing

1 - Rarely (0% - 10%)

Lifting <10 pounds

2 - Occasionally (11% - 40%)

Interpersonal Skills

3 - Frequently (41% - 75%)

Stooping

2 - Occasionally (11% - 40%)

Lifting >10 pounds

1 - Rarely (0% - 10%)

Reading

3 - Frequently (41% - 75%)

Kneeling

2 - Occasionally (11% - 40%)

Normal hearing both ears

3 - Frequently (41% - 75%)

Thinking

4 - Consistently (76% - 100%)

WorkingConditions:

1. General office environment.

2. Climate controlled environment.

3. May work some evenings and weekend hours to complete projects or meet the needs of the department.

4. May be required to work overtime as defined by the needs of the department.

Organizational Standards

§ Bill/transmit claims and follow up of assigned accounts.

§ Monitor assigned aging reports for payment, including under and/or overpayments.

§ Identify trends of specific payers.

§ Responsible for knowledge of reimbursement and billing guidelines and appropriate payment and/or allowable to maximize payment.

§ Maintain customer service with internal and external customers.

§ Enter applicable information into department data base.

Essential Duties & Functions

EssentialDuties & Functions:

The Senior Account Representative bills assigned claims as well as working the accounts receivable aging report on oldest outstanding claims, makes calls to appropriate payer to determine status of payment, works with insurance company regarding settlement and adjustment payments, resubmits claims as necessary for payment or resubmits additional information for review and payment, and is responsible for keeping documentation on each follow-up made.

Other Duties & Functions:

As assigned

The above duties and responsibilities may be essential job functions subject to reasonable accommodations. All job requirements listed include the minimum knowledge, skills, and/or ability deemed necessary to perform the job proficiently. This job description is not to be constructed as an exhausted statement of duties, responsibilities, and requirements. Employees may be required to perform any other job-related instructions as requested by their supervisor, subject to reasonable accommodations.