Senior Patient Account Representative - Rancho Cordova, CA

Position Description:

Health
care isn't just changing.  It's growing more complex every day.  ICD10
replaces ICD9.  Affordable Care adds new challenges and financial
constraints.  Where does it all lead?   Hospitals and health care
organizations continue to adapt, and we are vital part of their
evolution.  And that's what fueled these exciting new opportunities.  

Who
are we?  Optum360.  We're a dynamic new partnership formed by Dignity
Health and Optum to combine our unique expertise.  As part of the
growing family of UnitedHealth Group, we'll leverage our compassion, our
talent, our resources and experience to bring financial clarity and a
full suite of revenue management services to health care providers
nationwide.  

If you're looking for a better place to use
your passion, your ideas and your desire to drive change, this is the
place to be.  It's an opportunity to do your life's best work. 
 
Welcome
to one of the toughest and most fulfilling ways to help people,
including yourself. We offer the latest tools, most intensive training
program in the industry and nearly limitless opportunities for
advancement. Join us and start doing your life's best work.

This
position is responsible for the clerical duties relating to the timely
follow up and reconciliation of accounts billed to Commercial, Managed
Care insurance companies and some Government programs. Typical duties
include; review accounts receivable aging report; trace and appeal
unpaid and/ or erroneously paid or denied accounts; work selected return
billings for reprocessing; verify and adjust accounts according to
payer or program specifications; appeals, refunds and performs other
related duties as assigned.
 
Primary Responsibilities:

• Contact customers to determine reason for payment delinquency
• Negotiate and advise on collection of overdue/ incorrect claims and take appropriate action to recover overdue payments
• Handle unresolved inquiries/ issues
• Responsible for adhering to  collection practices
• May work with outside legal counsel and/or outside agencies in more complex collection cases
• Some work is completed without established procedures.
• Basic tasks are completed without review by others.

As a Senior Patient Account Representative you will need knowledge of: 

• Hospital or patient accounting department functions, operations and procedures 
• Medical terminology, procedure and diagnosis coding sufficient to assess accuracy of patient accounts 
• Covered insurance benefits, billing requirements and procedures for third party payers and/or Government Programs
• Data elements for UB04/ 1500 and/or State of California Medi-cal Program
• Operation of on-line computerized patient accounting systems and/ or electronic billing systems
• Accounting practices and procedures common to accounts receivable
• General clerical office practices and procedures 
• Medical terminology
• HCPCS/ CPT and ICD9/ ICD10 Coding understanding
• Hospital and patient accounting department functions
• Insurance policies and their benefits
• Data processing input devices
• Accounts receivable practices and procedures
• General clerical office practices  
• Knowledge of payer contracts