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Account Reps:

Follows up on unpaid accounts in patient accounting systems with the payers either by phone or via websites. Works payer denials based on claim process adjudication; Review accounts for possible underpayments; research contracts, guidelines and resolve payment with payer. Perform appeals with payer. Performs bad debt request transfers as applicable. Performs or requests adjustment and contractual write offs as applicable.•

Billers:

Reviews EPIC worklists and edits accounts as needed; Reviews Cirius claim edits and resolves edits; Reviews and resolves electronic acknowledgement payer rejections/denials; Rebills claims based on requests from Follow Up reps due to denials received. Resends claim as needed.•

Cash Posting Reps:

Posts payments; Work EPIC undistributed payment worklist; Posts adjustments related to payments. Processes refunds for accounts payable. Posts payment transfers from professional billing to hospital billing.•

Data Control Reps:

Enters charges; Reviews EPIC worklist accounts with charge issues and resolves; Research charge issues and follows up with departments as needed. Complete charge corrections including adding diagnosis, transferring, or reversing charges, combining accounts.•

Patient Advocacy Reps:

Completes and processes charity applications; Reviews and validates high dollar self-pay accounts before outsourcing to outside vendor; Handles patient calls and complaints. Requests referral of accounts to bad debt as applicable.• Maintains professional communication with various PFS staff, medical center staff, payors, physicians, and patients regarding the billing of services rendered at Stanford Medical Center. Communication may consist of telephone, correspondence, or in person contact.• Meets weekly individual productivity goals and standards while following planned priorities as set by the Team.