Patient Account Representative/Credit Reviewer - Granville Medical Center

Position Summary

Responsible for all duties related to servicing outstanding patient accounts and possible overpayments. Responsible for processing patient and insurance credit balances timely for resolution. and processing refunds according to the Hospital policy. Reviews insurance overpayments for accuracy and determines if appeals are needed. Files bankruptcy claims and appropriately adjusts account balances as needed. Reviews and posts Medicaid secondary adjustments to the patients' accounts as they are processed by insurance. Logs all Medicare crossover bad debts on the appropriate logs. Works closely with the collection agencies and communicates patient concerns for resolution. Works with county office on Wage Garnishment program for outstanding EMS balances.

Essential duties and responsibilities include:

Receives and reviews all overpayment requests from insurance companies, will determine if appeal is needed

Assist with PFS mail sorting and responding to patient inquires received

Reviews all patient credit balances and processes refunds of overpayments as needed

Reviews weekly Medicaid remits and posts secondary Medicaid adjustments as accounts are processed by insurance

Post all Medicare crossovers to Medicaid on the appropriate bad debt logs for processing

Review and process returned mail by searching for updated patient demographics as needed

Work with Granville County and EMS on processing Wage Garnishments for outstanding EMS balances

Assist with preparing and mailing out NC Debt letters on past due patient balances, answer patient concerns in reference to NC Debt and use skip tracing on returned letters to verify patient demographics as needed

Post adjustments for Medicaid or other account needs to correct patient outstanding balances

Review all Medicare and Medicaid overpayments creating credit balances and submit the appropriate credit balance reports quarterly

Performs all other duties as assigned by management

Qualifications

High school graduate with computer knowledge, minimum of one year previous experience in cash collections, prior hospital or medical business office experience preferred. Requires good organizational and communication skills. Ability to respect confidentiality; Proficiency in use of 10 key adding machine. Ability to handle cash collections accurately. Ability to communicate effectively with all customers, both internal and external. Working knowledge of Microsoft Outlook, Word and Excel.

Previous medical and/or customer service experience strongly preferred.

PI250210933