Patient Account Representative-Full time

Job Title: Patient Account Representative

Employment Type: Full-time

Shift: Day Shift

Location: Waterloo, ON (On-site)

About the Role

Join the MercyOne Family! We are looking to hire a Patient Account Representative. You will be responsible for registration and billing to third-party payers for Wheaton Franciscan Healthcare-IA. Adheres to Wheaton Franciscan Healthcare’s performance expectations and performs all defined services and other related duties in accordance with the mission of Wheaton Franciscan Healthcare.

Schedule

• Mon-Fri 07:30-16:00

Key Responsibilities

• Claims Processing:
• Receive claims and ensure a clean copy is sent to the insurance company.
• Review paper claims and fill in locators for the insurance company, updating the series system when needed.
• Transfer corrections onto the computer system.
• Send claims to the insurance company (electronically or via mail).
• Maintain knowledge of current standards with insurance companies and assure compliance.
• Claim Follow-up:
• Follow up on claims on first-time billings and take appropriate action.
• Resolve discrepancies in bill payment by following up with the insurance company.
• Initiate correspondence between the insurance company and the patient.
• Determine appropriate action (e.g., resubmitting claim, billing patient, billing secondary insurance).
• Billing Issue Resolution:
• Resolve billing issues with insurance companies, patients, and physicians’ offices.
• Follow up on correspondence with customers.
• Initiate communication with other health system departments for clarification.
• Respond to customer inquiries via phone and take appropriate action.
• Communicate results of investigations to customers.
• Document all communications and actions in the series system completely.
• Registration Functions:
• Create an account from clinic encounters.
• Enter charges into the computer system.
• Safety and Compliance:
• Adhere to all safety, infection control, and employee health policies and procedures.
• Attend required safety programs.
• Appropriately and consistently use personal protective equipment.
• Know and demonstrate departmental emergency procedures for fire, disaster, and other emergency situations.
• Report and remove unsafe equipment/furniture.
• Ask for assistance when needed to assure safety for all involved.
• Maintain a safe working environment and practice safe working habits.

Requirements & Tech Stack

• Basic Skill Set
• 0-2 Years of experience
• Minimum of 6 months medical office or insurance experience
• High school diploma or equivalent (GED)
• Associate's Degree (degree in accounting preferred)
• Billing experience preferred
• Experience with Brightree is a plus.