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Billing/Patient Accounts Representative at BEACON HEALTH SYSTEM in Three Rivers, Michigan

Posted in General Business 30+ days ago.

Type: Full-Time

Job Description:

Reports to Patient Accounts Manager. Performs a variety of duties related to the billing of patient accounts. Submits appropriate claim forms, electronic billing, maintaining the insurance file master, payment posting, and daily balancing.


  • MISSION: We deliver outstanding care, inspire health, and connect with heart.

  • VALUES: Trust. Respect. Integrity. Compassion.

  • SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Audit Process

  • Reviews patient accounts data including demographic patient/guarantor information, insurance information, and appropriateness of charges.

  • Communicates identified problems to appropriate supervisory personnel and participates in appropriate corrective action.

  • Ensures all appropriate documentation, including but not limited to, updated addresses, account notes, etc. has been entered into the Patient Accounting system for future reference.

Billing/Electronic Claims

  • Enters correct patient account data to impact the production of an accurate and appropriate UB-04 or CMS1500 claim form.

  • Ensures proper conformance with established government and third-party processing standards by working all edit errors to ensure clean claims are submitted to payers.

  • Corrects any errors in charging and/or insurance data to facilitate submission of a clean claim.

  • Submits and/or mails accurate and complete UB04 or CMS1500 claim forms to patients/guarantors and various government and third-party payors in a timely manner.

  • Demonstrates ability to submit primary governmental and commercial claims electronically daily. Ensure that status of claims and the billing secondary claims are submitted in an accurate manner.


  • Completes prompt follow-up of outstanding governmental receivables and takes appropriate action to ensure timely reimbursement.

  • Audits paylist weekly to ensure denied claims, due to inaccurate information, have been corrected and rebilled in a timely manner.

  • Works with patients and/or family member to ensure timely payments.

  • Keeps abreast of changes in policies, procedures, regulations and requirements of the governmental payor.

  • Request, prepares and submits necessary documents required for payment including but not limited to prior authorizations, consent forms and letter of non-coverage.


  • Demonstrates good interpersonal skills by communicating with customers, patients, physicians, co-workers and other departments in a friendly, caring, sincere and cooperative manner.

  • Communicates with internal and external departments or agencies in order to provide or obtain information to resolve outstanding governmental patient receivables.

  • Contribute to the overall effectiveness of the department

  • Completes other job-related duties and projects as assigned.


Associate complies with the following organizational requirements:

  • Attends and participates in department meetings and is accountable for all information shared.

  • Completes mandatory education, annual competencies and department specific education within established timeframes.

  • Completes annual employee health requirements within established timeframes.

  • Maintains license/certification, registration in good standing throughout fiscal year.

  • Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.

  • Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.

  • Adheres to regulatory agency requirements, survey process and compliance.

  • Complies with established organization and department policies.

  • Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:

  • Leverage innovation everywhere.

  • Cultivate human talent.

  • Embrace performance improvement.

  • Build greatness through accountability.

  • Use information to improve and advance.

  • Communicate clearly and continuously.

Education and Experience
  • The knowledge, skills, and abilities as indicated below are normally acquired through the successful completion of a High School Diploma or Equivalent. No previous experience is required.
Knowledge & Skills

  • Demonstrated technical knowledge of the UB04 and CMS1500 claim form and its use and application for government billings.

  • Demonstrated technical knowledge of government agency policies, procedures, regulations and requirements.

  • Organizational skills necessary to manage and control automated and manual billings and follow-up.

Working Conditions
  • Prolonged exposure to computer terminals.
Physical Demands
  • Occasional lifting of storage boxes weighing up to 50 pounds when filled with completed forms.

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