Patient Account Representative II/Biller at Eskenazi Health

Posted in Other 6 days ago.

Location: Indianapolis, Indiana

Job Description:

Division:Eskenazi Health


Req ID:6310

Schedule:Full Time


Salary Range:$14.58-$19.30

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.

FLSA Status


Job Role Summary

The Patient Account Representative II/Biller provides timely and accurate billing to facilitate optimized reimbursement, research and performance improvement initiatives. This includes the verification of billing data for accuracy and completeness, following regulatory requirements, and in order to resolve edits or exceptions detected during system processing of the claim in the patient accounting system, claim editing system or the payer by reviewing the medical record, facility protocol, other applicable documentation, and the understanding of payer denials, appeals process, and credit balances.

Essential Functions and Responsibilities

  • Proactively contributes to Eskenazi Health's mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County; models Eskenazi Health's values of Professionalism, Respect, Innovation, Development and Excellence

  • Responsible for working assigned work queues based on payer and dollar amount to include credit balances

  • Completes payer appeals based on underpayment, timely filing, medical necessity and prior authorizations for low dollar hospital accounts

  • Responsible for resolving claim edits for low dollar hospital accounts while adhering to payer guidelines and regulations

  • Takes a leadership role on special projects, including providing coverage for team members who are out of the office.

  • Makes phone calls to patients and insurance companies to obtain information required to resolve patient accounts

  • Serves as a resource to other departments to resolve problems and expedite billing and collection processes

  • Keeps up to date on account billing and collection rules and regulations, contract terms and conditions with regards to timely filing and service pre-certifications and authorizations

  • Responsible for identifying and trending payer rejections and denials; implements system process improvements to prevent future rejections and denials

  • Completes Payer Correspondence Work Queues using first in first out (FIFO) method for assigned payer and account balance

  • Answers e-mails and voicemails in a timely manner

  • Participates in monthly staff meetings to educate new payer habits and etc. as needed

Job Requirements

  • Associate degree in business-related field preferred

  • Two years in a medical billing environment may be accepted in lieu of education

  • Previous training in medical practice software, coding and insurance filing

Knowledge, Skills & Abilities

  • Working knowledge of Epic, AdvancedMD, STAR, OnBase, Internet Explorer, Windows and other PC applications as required and necessary for job assignments

  • Ability to utilize support systems such as Onbase, nThrive, and other software applications

  • Excellent verbal, written and organizational skills

  • Must be detail-oriented with the ability to multitask due to the large volume of accounts being worked at one time

  • Ability to complete tasks within given timeframes, remaining productive and goal-oriented

  • Demonstrates excellent problem-solving skills to research issues with accounts, holds and claims

  • Ability to troubleshoot errors and resolve accounts within a reasonable amount of time

  • Ability to function effectively as a team member and respond to changes in work processes, leadership, and systems in a constructive manner

  • Knowledge of correct charge entry, procedure and diagnosis coding, and medical necessity linkage

  • Ability to use computer 10-key entry and operate a calculator

  • Knowledge and understanding of medical terminology and human anatomy

  • Significant knowledge of procedure and diagnosis coding

  • Knowledge of specific laws and regulations for Medicare, Medicaid and other third-party payers

  • Ability to communicate effectively and clearly

  • Ability to meet production and accuracy benchmarks and goals as determined by Management

  • Ability to function effectively within system and software applications

  • Ability to plan, analyze, problem-solve, organize and prioritize work

Accredited by The Joint Commission and named one of the nation's 150 best places to work by Becker's Hospital Review for four consecutive years and Forbes list of best places to work for women, and Forbes list of America's best midsize employers' Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care - Center of Excellence in Women's Health, just to name a few.

Nearest Major Market: Indianapolis