Patient Account Associate - Billing and Accounts Department
Duke University Health System
Location: Durham, North Carolina
Internal Number: 120690
Duke Homecare & Hospice offers hospice, home health and infusion services. Hospice care is offered to terminally ill patients in their home, skilled-nursing facilities, assisted-living facilities, and at our two inpatient facilities located in Hillsborough and Durham, North Carolina.
Location: Durham 27710 (ON SITE)
Responsible for performing the reimbursement functions of billing and collections through evaluation, documentation and obtaining any information required to insure complete accuracy in creating a claim and collecting from a pay source. The Patient Account Associate position can also function in the roll for cash application and the responsibilities tied to this function. This position must be able to work independently to process complex patient medical claims by therapy and payer specifications to assure accurate and timely claim submission and follow up through final payment and cash posting.
Job Duties 1. Insures confidentiality of patient information through HIPAA Compliance. 2. Maintains knowledge base on changes to reimbursement, including but not limited to specific managed care contracts, Medicare/Medicaid guidelines, and third party insurance payers. 3. Initiates appropriately timed correspondence and telephone contact to clarify and explain account or coverage situation with patients or guarantors, employers, insurance companies, and sponsoring agencies; obtains cooperation toward settlement of account. 4. Maintains accountability for the prompt processing of claims including billing, claims transmission, and the collection of those claims, for a set group of accounts assigned. 5. Obtains and follows up on all documentation needed in order to bill. 6. Notifies supervisor and data manager regarding any medical documentation requested by payer sources, or patients. 7. Investigates denials from insurance companies to insure claim resolution. 8. Prioritizes accounts to maximize dollars in collections. 9. Notifies supervisor of problem accounts and/or clinical issues that need to be addressed related to billing and collections. 10 Researches and resolves delinquent accounts to insure timely collections and reduce DSO. 11. Clearly notates databases as specified by supervisor. 12. Submits appropriate documentation for adjustments, write-offs, refunds or bad debt to the appropriate Supervisor, Accounts Receivable. 13. Communicates to supervisor any IT issues. 14. If Patient Account Associate is assigned to the cash application function, that party accurately and efficiently performs all duties related to the cash application function as outlined by supervisor. 15. Performs special projects as assigned and other duties as requested.
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred.Additional training or working knowledge of related business
Two years experience working in hospital access, physician office or billing and collections or an equivalent combination of relevant education and/or experience.
Degrees, Licensures, Certifications
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