Patient Account Representative PRN

Overview

Pacific Grove Hospital is a nationally recognized 68 bed acute psychiatric and chemical dependency treatment center offering inpatient & outpatient services for psychiatric illnesses, addictions & co-occurring disorders. Our hospital offers comprehensive training, dynamic leadership, and personalized support so you can achieve your greatest potential.

Responsibilities

• Call and status outstanding claims with third party payors.
• Review claims issues and make corrections as needed and rebill.
• Utilize claims clearing house to review and correct claims. Resubmit electronically when available.
• Review explanation of benefits to ascertain that claim processed and paid correctly.
• Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.
• Manage daily productivity via patient accounting system and productivity reports. Needs to maintain an average of 30-40 accounts worked per day minimum.
• Prorate patient accounts and monitor that balance due is in the correct financial class.
• Report an overview of the week to the BOD and participate in AR meetings.
• Gather and interpret data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.
• Assist financial counselors as needed.
• Alert Financial Counselors and Business Office Director / Manager of all benefit eligibility matters that suggest or challenge reimbursement.

Other Functions

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