Gov 3rd Part Clms Foll-up Rep-patient Accounts
Maine Medical Center (Southern/Portland, Maine)

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Job Details:


SUMMARY OF POSITION DESCRIPTION:

Conducts follow up activities in relation to government/third party payers to ensure prompt reimbursement due the hospital. Analyzes rejected claims to determine cause of denial and initiates appropriate action to adjudicate claims. Communicates with hospital personnel, external organizations and third party payers to obtain missing and/or incomplete information. Responds to inquiries from patients, patient representatives and third party payers regarding government/third party claims

MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

1. Ability to read and comprehend computer printouts and reports.

2. Interpersonal skills necessary to deal effectively with patients, peers, and governmental/third party payors in the resolution of patient billing problems; including the ability to compose letters.

3. Comprehension of governmental/third party billing regulations and instructions.

4. Ability to review and verify patient, governmental/third party and supplemental payor accounts, respond to inquiries from patients, third party payors, and other hospitals; complete records, logs, and forms at the appropriate professional level.

5. Skills necessary to mathematically compute and complete governmental/third party payor and supplemental payor claims; ability to recognize and resolve errors on patient bills and ensure compliance with State and Federal regulations.

6. Knowledge and use of office equipment to include computer terminals, calculators, typewriters, micro-fiche readers/printers, and photocopiers.

7. 2-3 years hospital claims resolution experience with government and 3rd party payers



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