Patient Account Representative - Accounts Receivable

Who you are:

As a Patient Accounts Representative - Billing for Catholic Medical Center (CMC), you'll be responsible for accurate billing of hospital and/or professional accounts, ensuring timely claim submission, reimbursement from various third-party payers, ensuring proper account documentation, charging and refund activities in the hospital's electronic billing system and pursuing follow-up efforts on open accounts.

This is a benefitted full time (40 hour) Monday - Friday role and comes with a Bonus!

Note: This is a hybrid position offering 2 days remote after training.

What you'll do:

• Work daily electronic billing work queues and paper claims submission by resolving payer edits and mailing/releasing claims to the clearing house or third party payers.

• Document billing activity on the account; ensure compliance with all applicable billing regulations for assigned payers and report any suspected/questionable compliance/billing concerns to the attention of department leaders.

• Review and correct all claim denials that are communicated via Explanation of Benefits (EOB), denial reports, denial management system or correspondence from the insurance carrier or others to determine what follow-up action is necessary including initiating the adjustment or appeals process if needed.

• Review and process all required daily reporting activities including late charges, diagnosis changes, charge corrections and initiates corrected bills to the payer as needed.

• Determine proper disposition of credit balances and take backs (from payers) on accounts and initiates refunds, adjustments or corrected claims.

• Monitor claim rejections for trends and issues, report these findings to the team lead/manager to reduce future claim rejections.

• Perform follow-up on unresolved open accounts and document all reasons for reimbursement delays as well as actions taken within the electronic billing system.

• Monitor workload for aging inventories and timely filing.

• Practice excellent customer service skills by answering patient, internal associates and third-party questions and/or addressing billing concerns in a timely, professional and efficient manner.

What you'll bring:

• High school diploma or equivalent required, Associates degree preferred.

• Minimum of 1-2 year's medical billing experience in a health care setting preferred.

• Knowledge of basic patient accounting processes and healthcare terminology strongly preferred.

Who we are:

Catholic Medical Center ("CMC") is a nonprofit, regional health system committed to delivering the highest quality and most advanced healthcare to patients across New Hampshire. CMC is the home of the nationally-renowned New England Heart & Vascular Institute, rated among the top cardiovascular programs in the country.

We are driven by our mission to offer health, healing, and hope to every individual who seeks our care, and we live by our values of Respect, Integrity, Compassion, and Commitment.

CMC is proud to be named to the Forbes list of America's Best-in-State Employers for two consecutive years. This prestigious award is presented by Forbes and Statista, Inc., and is based on 2.1 million employer recommendations from employees working for companies with more than 500 employees in the United States.

With our award-winning clinical programs, primary care network and dedication to community, CMC is fostering a healthier New Hampshire, every day.

Catholic Medical Center is an equal opportunity employer and we embrace diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.