Patient Account Representative, Rev Integrity and Util
Full Time, 80 Hours Per Pay Period, Day Shift
Covenant Health Overview:
Covenant Health is East Tennessee’s top-performing healthcare network with 10 hospitals and over 85 outpatient and specialty services, and Covenant Medical Group, our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned, not-for-profit healthcare system and the area’s largest employer with over 11,000 employees.
Covenant Health is the only healthcare system in East Tennessee to be named six times by Forbes as a Best Employer.
Insurance Claim Follow Up Overview:
Seeking detailed oriented candidate with strong problem-solving & verbal-written communication skills, as well as excellent time management.
Position Summary:
This position has the responsibility of working patient accounts as defined by the department established policies and procedures under the Manager and Supervisor within the department. Specifics and volume of work is defined by the functional area within the Business Office that the employee is assigned. All work shall be completed in a timely and accurate manner. Review patient accounts for resolution- check status with insurance company for billed claims that have not processed & determine what may be needed in order for claim for finalize. Review accounts with full or partial claim denials to find out root-cause & determine best course of action for proper resolution.
Responsible for learning & understanding payer rules, as well as state/federal guidelines.
Responsible for prioritizing & completing work per the departmentâÃÂÃÂs productivity & quality standards.
Responsible for facilitating communication between insurance company and the patient to resolve issues holding up claims processing, such as: incorrect demographic information or coordination of benefits.
Responsible for facilitating communication between other Covenant departments in order to correct any issues with billed claims to ensure correct billing and proper claim processing.
Recruiter: Kathleen Rice || kkarnes@covhlth.com || 865-374-5386
Minimum Education:
Minimum Experience:
Licensure Requirements:
| None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED.
One to Two (1-2) years’ experience in health care is preferred. Computer experience is required. Knowledge of medical terminology, claims submission, customer service is preferred. Expected to perform adequately within the position after working at least three (3) to six (6) months on the job. Must be familiar with insurance plans and requirements and collection practices e.g. Fair Debt Credit and Collection Act. Seeking detailed oriented candidate with strong problem-solving & verbal-written communication skills, as well as excellent time management.
None.
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