Patient Account Representative – Home Health & Hospice

Under the supervision of the Revenue Cycle Manager, this position is responsible for the timely and accurate billing of commercial / group insurance / Medicare / Medi-Cal / managed care and self-pay home health / hospice accounts, posting of payments / remittance advices, review of unpaid claims / patient accounts and use procedural guidelines to reduce the outstanding dollars on accounts receivable.

This includes the billing and electronic submission of claims; performing consistent collection and accounts receivables follow-up practices;

processing and posting of payments; identification and preparation of appropriate write-offs; accurate resolution of all credit balances and timely response to assigned payer correspondence to ensure proper claim reimbursement.

Understands Home Health and Hospice billing rules and demonstrates compliance with federal and state billing requirements.

Ensures compliance to payer contracted billing requirements. Verifies all pertinent data for completeness and accuracy. Collaborates with all teams and payers to effectively process clean claims, obtain reimbursement, and resolve patient accounts.

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County, and San Gabriel Valley region.

The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services.

The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology.

For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.

Required Skills

• Competency in use of a computer, 10-key adding machine, calculator, fax machine, photocopy machine and multi-phone line.
• Ability to perform multiple tasks, good mathematical skills, sound decision making abilities and good verbal and written communication skills.
• Comprehensive knowledge in word processing and spreadsheets (Excel and Word) and ability to learn new computer systems and software.
• Must be able to prioritize and complete duties in a timely manner to accomplish both individual and team goals.

Required Experience

Required :

• High school graduate
• Medical terminology knowledge
• Knowledge of commercial / group insurance HMOs / PPOs, Medicare, Medi-Cal billing requirements and regulations.
• Understanding of CMS rules and regulations concerning accurate claims submission.
• Knowledge of payment posting, proficient in reading and comprehending ERAs and SPRs.

Preferred :

• Prior knowledge in years in home health / hospice commercial and group insurance billing and collection experience.
• Two years college or medical billing certificate
30+ days ago