Patient Accounting Representative - Reimbursement

Halifax Health is seeking a Patient Accounting Representative for our Patient Business and Financial Services Department.

This individual will assist and lead the Patient Accounting Representative team under guidance of the supervisor. Assist in escalated issues with patients, guarantors and third parties on accounts to resolve any questions or concerns towards satisfying account balances with patient/third party liability. Assess all options to patient’s account including payments, contracted payment plans, and financial assistance. Help create worklists and reports to identify account resolution for Patient Accounting Rep team. Help team identify any charity or financial assistance needs; all documentation and coordination with patients will be worked until determination of approval. Document all patient/ third party activity and communication in host systems.

• Minimum high school graduate or equivalent required. Associates or Bachelor’s degree from accredited institution is preferred.
• Minimum of two years experience in healthcare billing and/or business office setting, preferably in hospital billing.
• Must be able to communicate with patients effectively while maintaining customer service expectations.
• Preferred experience in Meditech and/or Athena EMR systems.
• General PC knowledge in business setting is required.
• Must have good oral and written communication skills.

• Timely and accurate posting, adjusting and reconciling of funds received via lockbox payments, electronic funds transfers and mail with posting accuracy of 99% or greater.
• Forwards potential third party or patient refunds to the Refund Specialist based on credit balances created from payments and/or adjustments posted to patient’s accounts.
• Responds to system or manual tasks in a timely manner.
• Prepares daily reconciliation of cash posting to Accounting Department.
• Applies payroll deductions within 48 hours of receipt.
• Applies payments and adjustments not completed by electronic remittance posting.
• Prepares remote bank deposits and processes credit card transactions daily with 100% accuracy.
• Correctly identifies remittance codes and applies them to individual patient’s accounts as received by insurance companies. Validate track and trend remittance codes for process improvement.
• Correctly identifies underpaid claims in accordance with hospital insurance contracts by applying underpayment codes correctly to patient’s accounts, based off information received by insurance companies.
• Post insurance payments to the correct insurance plans as identified by hospital contracts. Updates patient accounts with corrected insurance plans. Track and trend insurance plan errors and forward to registration areas for improvement.
• Performs research related to unidentified payments received to determine the appropriate accounts for posting.
• Review and complete correspondence and faxes in a timely manner.
• Contributes to effective working relationships by demonstrating a positive and helpful attitude with co-workers.
• Maintains privacy strictly adhering to HIPAA guidelines.
• Performs other duties as assigned.
• Processes third party and patient refunds in adherence with company policy.
• Researches credit balance accounts for possible refund or retraction.
• Reviews incoming refund requests, via mail or fax from insurance or audit companies, for validity and responds appropriately.
• Sends any necessary adjustments, posting corrections or payment transfers to the Payment Poster Specialist.
• Coordinates refunds/retractions with third party vendors working on behalf of Halifax Health in accordance with company policy.
• Compose letters or faxes disputing refunds to insurance or audit companies.
• Call insurance companies to obtain additional information concerning the credit balance.
• Complete audits from insurance companies or internal compliance in a timely manner.
• Submits refund posting report to the Accounting department weekly.
• Responds to system tasks in a timely manner.
• Contributes to effective working relationships by demonstrating a positive and helpful attitude with co-workers.
• Maintains privacy strictly adhering to HIPAA guidelines.
• Performs other duties as assigned.

Recognized as one of the 50 Top Cardiovascular Hospitals™ in the United States by IBM Watson Health™, Halifax Health serves Volusia and Flagler counties, providing a continuum of health care services through a network of organizations including a tertiary hospital, two community hospitals, urgent care clinics, psychiatric services, a cancer treatment center with five outreach locations, the area’s largest hospice, a center for inpatient rehabilitation, outpatient rehabilitation clinics, primary care walk-in clinics, a clinic specializing in women’s health, a pediatric care community clinic, five pediatric medical practices, a home health care agency and an exclusive provider organization. Halifax Health offers the area’s only Level II Trauma Center, Thrombectomy-Capable Stroke Center (TSC), Center for Transplant Services, Pediatric Intensive Care Unit, Child and Adolescent Behavioral Services, complete Neurosurgical Services, OB Emergency Department and Level III Neonatal Intensive Care Unit that cares for babies born earlier than 28 weeks. For more information, visit halifaxhealth.org.