[Remote] Patient Accounting Representative

Note: The job is a remote job and is open to candidates in USA. Kaiser Permanente is a healthcare organization seeking a Patient Accounting Representative. The role involves performing billing and follow-up for hospital or professional claims, ensuring accurate and timely submission of claims, and resolving denials to maximize reimbursement according to payer agreements.

Responsibilities

• Performs accurate and timely billing of insurance claims in accordance with policies and procedures of Maui Health and in compliance with State/Federal regulations, payer health plan guidelines, and third-party payer requirements
• Expedites larger dollar accounts to ensure revenue optimization for prompt payment
• Follows up timely on payment with insurance companies, agencies, payers and/or patients ; researches and takes action as required on outstanding accounts
• Audit payments and appeals (as needed) to ensure Maui Health has received corrected, expected payment from payers in accordance with contract terms
• Responds to patient and insurance inquiries promptly and courteously
• Performs audits as needed for quality control and to ensure efficient follow up
• Collects monies owing for all services rendered, including third party payers, employers, and guarantors
• Document all actions into account notes
• Resolves payer denials, including submission of appeals as needed
• Communicates timely and appropriately with Team Lead/Supervisor to identify and resolve payer/claim submission issues
• Analyzes and takes appropriate action steps according to MHS protocols
• Strives to achieve targeted benchmarks and exceed collection goals for prompt account resolution

Skills

• Minimum one (1) year collections or administrative experience
• High school diploma
• Demonstrated ability to perform diversified clerical functions and basic accounting procedures
• Demonstrated ability to motivate debtors to pay
• Demonstrated knowledge of and skill in adaptability, change management, conflict resolution, customer service, influence, interpersonal relations, oral communication, problem solving, teamwork, and written communication
• One (1) year experience medical insurance claims processing, demonstrating knowledge of Medicaid, Medicare, & Commercial payer requirements
• An Associates Degree or Bachelors Degree in Business Administration, Finance, Accounting or Healthcare-related field may be substituted for one (1) year experience as a Patient Account Representative
• Knowledge of medical terminology, CPT-4 and ICD-10-CM coding
• 10-key by touch
• Post high school coursework in accounting

Benefits

• Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency.
• The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package.
• Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.

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