Patient Business Services Associate
The primary purpose of the PBS Associate position is to follow-up on claims within regulatory guidelines. The PBS Associate must ensure that all claims have a follow-up action according to timely filing limits and that all follow-up activities are performed accurately.
- Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls in order to ensure prompt payment of medical claims.
- Responds to requests made by third party payors and in a timely manner.
- Responds timely to patient account inquires received from customer service.
- Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments. Makes recommendations for resolution.
- Pursues appeals when available. Initiates communication with coding team and clinical staff when coding related and medical necessity appeals are warranted.
- Consistently reviews processes and recommends any areas of opportunities with assigned payors
- Written communication demonstrates clear action taken on each account as well as what further action is needed to capture payment. Work output is documented clearly, so that various departments involved in resolution can review the account.
- Achieves improved team performance by completing assigned special projects.
- Identifies, analyzes and escalates trends affecting AR collections.
- Provides verbal and written communication while assisting management in addressing issues with difficult claims and aging.
- Facilitates department training by assisting other team members in payor source education and knowledge sharing as requested by Management.
- Ability to meet departmental standard for quality and productivity
Required: High school diploma.
Required: Three years of experience in billing, insurance follow-up, or collections in a medical or hospital business office setting. Must pass pre-employment skills test as required and administered by Human Resources.
Preferred: Two years billing governmental or commercial insurance and insurance collections experience.
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