Patient Account Rep - Union Hospital - Terre Haute, IN
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Files various insurance claims; i.e. primary, secondary, and disability.
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Sends requested additional information to various insurance companies.
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Assists patients and insurance companies on the phone with insurance problems or questions.
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Assists patients at the window/counter.
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Sets up insurance.
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Answers insurance inquiries.
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Verifies insurance eligibility.
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Obtains necessary referrals and authorizations.
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May review Medicare, HMO, and EOBs for correct payment and information.
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May prepare related types of letters:
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Referral letters
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Return to work letters
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Medical necessity letters
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May complete necessary nursing home request letters.
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May process missing ticket reports.
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Works outstanding invoice/reports, contacting insurance companies regarding claim status.
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May adjust and/or correct fees, procedures, and diagnosis; i.e. HMO, etc.
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Audits patient accounts.
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Utilizes Union Hospital computer system to print patient information for distribution to the department.
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Posts Hospital charges.
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Requests or obtains EOBs for inquiry purposes.
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Requests referral forms.
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Attends insurance meetings, both in office and outside of office.
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Interacts with physicians to obtain proper diagnosis for insurance purposes.
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Sets up new patient insurance information.
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Sets up insurance and employers into the computer master file.
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Assists patients on indigent care programs in obtaining goods and services.
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Calls specialists with referral numbers.
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Calls for precertifications and authorizations.
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Performs other job related duties as assigned.
CUSTOMER SERVICE STANDARDS
All employees are expected to complete their responsibilities in accordance with the Union Health System Values:
Patient Focused – Place patients first – every time
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Listen and understand with compassion.
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Communicate effectively with patients, families and all levels of the healthcare system.
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Consistently treat patients and families with respect and kindness.
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Anticipate, understand, and promptly act on patient needs and expectations.
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Apply lessons from experiences to improve patient care and safety.
Collaboration – Work together for optimal results
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Find solutions-resolve conflicts.
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Encourage ideas, respect opinions, and appreciate the contribution of others.
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Strive to meet the diverse needs of all involved.
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Be confident without arrogance.
Integrity – Always be honest and ethical
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Demonstrate honesty, truth and mutual respect.
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Display a positive attitude and encourage others.
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Take responsibility for actions and behaviors; be accountable.
Transparency – Openly share the “why” in what we do
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Maintain confidentiality while accurately and willingly sharing information.
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Interact with respect and an open mind.
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Provide secure access to appropriate information.
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Evaluate and communicate our performance to drive improvement.
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Be open an d honest about success and failures.
Stewardship – Be responsible with lives and
resources
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Behave as if you owned the organization by being fiscally responsible.
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Commit to continuous improvement, education, and innovation.
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Contribute to a safe, positive and productive environment.
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Work together to grow a stronger and healthier Wabash Valley.
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TRAINING, EXPERIENCE, SKILLS AND ABILITIES NEEDED:
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Working grasp of standard written and verbal English, good spelling, accomplished at basic business math.
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Must meet and deal successfully with a wide variety of people.
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Should be knowledgeable of ICD-9, CPT coding.
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Medical terminology helpful.
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Should possess good telephone skills.
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Must possess one year of insurance experience in a medical office setting.
PHYSICAL DEMANDS:
While performing the duties of this job, the employee is regularly required to talk or hear.
The employee frequently is required to sit and use hands to finger, handle, or feel objects, tools, or controls.
The employee is occasionally required to stand, walk, and reach with hands and arms.
Employee must frequently lift and/or move up to 10 pounds.
Specific vision abilities required by this job include close vision and the ability to adjust focus.
OHSA III Classification
TOOLS AND EQUIPMENT:
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Computer, calculator, and general office equipment.
EOE/M/F/Vet/Disabled
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