Advertised Patient Account Representative - Insurance Claims Follow Up

Patient Account Representative - Insurance Claim Follow-Up

Patient Account Representative - Insurance Claim Follow-Up

Full Time, 80 Hours Per Pay Period, Day Shift

Covenant Health Overview :

Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times.

Insurance Claim Follow Up Overview :

Seeking a detailed oriented candidate with strong problem-solving & verbal-written communication skills, as well as excellent time management.

Responsibilities :

• Review patient accounts for resolution- check status with insurance company for billed claims that have not processed & determine what may be needed in order for claim to finalize.
• Review accounts with full or partial claim denials to find out root-cause & determine best course of action for proper resolution.
• Responsible for learning & understanding payer rules, as well as state / federal guidelines.
• Responsible for prioritizing & completing work per the department's productivity & quality standards.
• Responsible for facilitating communication between insurance company and the patient to resolve issues holding up claims processing, such as : incorrect demographic information or coordination of benefits.
• Responsible for facilitating communication between other Covenant departments in order to correct any issues with billed claims to ensure correct billing and proper claim processing.

Position Summary :

This position has the responsibility of working patient accounts as defined by the department established policies and procedures under the Manager and Supervisor within the department. Specifics and volume of work is defined by the functional area within the Business Office that the employee is assigned. All work shall be completed in a timely and accurate manner.

Responsibilities :

Qualifications : Minimum Education :

None specified; will accept any combination of formal education and / or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED.

Minimum Experience :

One to Two (1-2) years' experience in health care is preferred. Computer experience is required. Knowledge of medical terminology, claims submission, customer service is preferred. Expected to perform adequately within the position after working at least three (3) to six (6) months on the job. Must be familiar with insurance plans and requirements and collection practices e.g. Fair Debt Credit and Collection Act.

Licensure Requirements :

None.