Job Description

Position Overview

We are seeking a dedicated and detail-oriented Patient Account Representative II to join our dynamic team! If you have a strong understanding of Revenue Cycle Management processes, particularly in handling denials and appeals, we would be thrilled to hear from you.

Key Responsibilities

Analyze denial cases to determine the most effective course of action for appeals or resubmissions.
Prepare and submit accurate and compliant appeals for denied claims.
Collaborate with billing, coding, and clinical staff to gather necessary information for appeals and efficiently resolve denial issues.
Maintain comprehensive records of denial cases, including appeals filed and communications with insurance representatives.
Monitor the status of appealed claims and follow up with insurance representatives to expedite resolutions.
Generate and analyze reports on denial trends, identify root causes, and recommend improvements to processes.
Qualifications

Education, Licensure, Certifications, & Experience:

High school diploma or equivalent.
At least 2 years of recent experience in claims processing and denials management.
1 year of recent experience using the EPIC system.
Familiarity with the EPIC EMR system is preferred.
Required Skills

Strong analytical skills to assess denial reasons, identify trends, and develop strategies to minimize denials.
Excellent written and verbal communication skills for effective interactions with internal staff and insurance representatives.
Exceptional attention to detail and accuracy in documentation and submissions.
Ability to work collaboratively with multidisciplinary teams to achieve common goals.
Comprehensive understanding of billing regulations, coverage guidelines, and the appeals process.
Physical Requirements

Sitting: 90%
Standing/Walking: 10%
Occasional lifting and carrying of supplies and paperwork weighing up to 40 pounds.
Occasional pushing and pulling to move supplies and equipment.
Occasional climbing of stairs to access different levels of the building.
Occasional stooping, kneeling, bending, or crouching to file in low cabinets, purge old bills, and print forms.
Occasional reaching, handling, and fingering to complete paperwork, use computers, file documents, and answer telephones.
Frequent talking, hearing, and seeing to interact with staff and customers effectively.
Environmental Conditions

Work Environment: Inside
Location: Onsite or Remote
Employment Type: Full-Time
Salary: $ 41,600.00 52,000.00 Per Year

Job Tags

Full time,

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