Accounts Representative

CASS REGIONAL MEDICAL CENTER

Job/Position Description Employee Name:

______________________________

Department Name:

Business Office Title:

Accounts Representative Level one

EEOC Classification:

Clerical-Non-Exempt

PART ONE

Dimension and Description Primary Purpose :

To ensure that all billing and collection is done in a timely manner and in accordance with the provider insurance contract.

Formal Policy-Setting Responsibilities :

Formally responsible for making recommendations regarding policies associated with the job's purpose and essential responsibilities.

Routine Decision Making :

Accurate billing setup. Understanding of ICD-10 and CPT codes guidelines. Billing guidelines for services billed per payer.

Formal Supervisory Responsibility:

Formally responsible for providing input into policies associated with the job's purpose and essential responsibilities.

Required Knowledge:

Knowledge of state and federal rules and regulations, to include Critical Access Hospital; billing standards; CPT and ICD-10 coding guidelines; medical computer software programs; and insurance policies and procedures, Washington Publishing Company denial and remittance codes. CCI and NCCI edits, understanding of accurate use of modifiers, Excel.

Required Skills and Ability:

Management skills; application and maintenance computer skills; verbal and written communication skills, to include writing appeals; knowledge of office machines; and 10-key ability. Ability to prioritize and work independently, problem solving skills,

Unusual Working Conditions:

None. Education and Certification required for the position : High school education.

P ART TWO

Essential Responsibilities and Tasks A. Follow-up on all commercial insurance, MC MCD & Liens Accounts (80% of time) 1. All accounts are reviewed for accuracy of billing guidelines to include

CPT, ICD

10, and modifier usage. Aging is worked every 30 days. 2. Denials are reviewed and reported daily, identifying education needs, to insure accurate billing for services. (Meditech and Cirius) Log denials for further education. 3. Unapplied credits are worked monthly. 4. Contact IS for any computer issues immediately. B.

Customer Service:

Is able to handle all aspects of accounts resolution in order to resolve any issue with patient/account. (i.

e:

insurance issues, rebilling claims, credit balances) (15% of time) 1. Provides Excellent Customer service to all individuals representing the Cass Regional Medical Center Values. 2. Acts as back up to Cashier or PBX operator as needed. 3. Acts as a financial advocate for the patient in understanding and reconciling statements and or daily charges. Accepts payments and posts accurately. Documents all conversations completely and timely. Accepts and processes Financial Assistance and Patient Concerns according to policy. 4. Closes out cashier menu, posts all payments with 100% accuracy at the end of each day. Prepares deposit according to policy. 5. Answers phones cheerfully by 2nd ring, identifying yourself and Cass Regional. Phone line is always open and all voicemails are answered by the end of the day. 6. Accurate application of Financial Class, transaction codes, payer class etc. C. Actively participates in Business Office Operations and all other duties as assigned. (5%) 1. Willingly takes on other duties as assigned. 2. Uses available resources efficiently and effectively. I.E., Manuals, Internet Payer Websites, etc. 3. Participates in process improvement for business office procedures and actively follows all policy and procedures of the department. 4. Actively participates and follows all department policy and procedures.