Navigant Patient Account Support Representative- Navigant Cymetrix- Birmingham, AL in Lewisville, Texas
Navigant Consulting, Inc. (NYSE: NCI) is a specialized, global professional services firm that helps clients take control of their future. Navigant’s professionals apply deep industry knowledge, substantive technical expertise, and an enterprising approach to help clients build, manage and/or protect their business interests. With a focus on markets and clients facing transformational change and significant regulatory or legal pressures, the Firm primarily serves clients in the healthcare, energy and financial services industries. Across a range of advisory, consulting, outsourcing, and technology/analytics services, Navigant’s practitioners bring sharp insight that pinpoints opportunities and delivers powerful results. More information about Navigant can be found at navigant.com.
Navigant Cymetrix unites the strengths of four category-leading companies to address the complexities of today’s healthcare system. We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.
Under general supervision and according to established policies and procedures, the Patient Account Support Representative performs a variety of duties related to the third party recovery function of the MSO. Such duties may include, but are not limited to, the following: 1) obtains claim status, 2) receives and reviews denials, 3) performs data entry of charges into various carrier systems, 4) resubmits reviews and corrected claims and supporting documentation as needed, 5) communicates with third party payors to obtain payment., and 6) communicates issues to management in a timely manner. Performs other duties as requested by supervisor.
Must be self-directed / self-motivated; must have good communication and interpersonal skills.
Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.
Accept responsibility for one’s own work; works independently.
Recognize the rights and responsibilities of patient confidentiality.
Convey empathy and compassion to those experiencing pain, physical or emotional distress and/or grief.
Relate to others in a manner which creates a sense of teamwork and cooperation.
Communicate effectively with people from every socioeconomic, cultural and educational background.
Exhibit flexibility and cope effectively in an ever-changing, fast-paced healthcare environment.
Perform effectively when confronted with emergency, critical, unusual or dangerous situations.
Demonstrate the quality work ethic of doing the right thing the right way.
Maintain a customer focus and strive to satisfy the customer's perceived needs.
Works ETM returns, tickler returns, transfers, claim edits and audit trail daily.
Work correspondence workbasket daily.
Works paper claims daily.
Processes denials from third party payors on patient accounts.
Works ETM views to obtain claim status on patient accounts.
Retrieves medical records needed to file appeals/ reviews to carriers.
Access payor websites for on-line keying of charges.
Research websites for specific coding policies (i.e., Encoder, CCI edits, CMS, etc.).
Research accounts related to recoupments and refunds.
High dollar invoices addressed monthly.
Aged receivables addressed monthly.
Low dollar invoices addressed monthly.
Performs various data entry functions to correct information to accurately process charges.
Verifies and corrects insurance information in registration, visit and COB and refiles claims to correct carrier.
Posts appropriate contractual or other adjustments utilizing the payment posting function.
Enters various charge entry data utilizing the charge entry function.
Creates case and links appropriate invoices using case management function.
Provides responses in a timely manner by using available resources.
Receives incoming and outgoing calls and addresses billing inquiries from third party payors and MSO divisions.
Responds to work related emails in a timely manner.
Attends team meetings and other MSO functions.
Completes all required training and any ongoing educational needs.
High school diploma or equivalent.
1-3 years of related experience in insurance billing, customer service related field or educational equivalent preferred.
General knowledge of payer specific or medical specialty billing preferred.
Knowledge of CPT and ICD-9 coding preferred.
Good written and verbal communication skills.
Basic computer skills.
Strong conceptual, as well as quantitative and qualitative analytical skills
Work as a member of a team as well as be a self-motivator with ability to work independently
Constantly operates a computer and other office equipment to coordinate work
Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data
Generally works in an office environment
The company offers competitive compensation packages including an incentive compensation plan, comprehensive medical/dental/life insurance, 401(k) and employee stock purchase plans.
Navigant does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Navigant and Navigant will not be obligated to pay a placement fee.
Navigant is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.
Navigant will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.