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Healthcare Representative 2 - Bilingual

Location: Lexington, KY, United States
Job # 11867521
Date Posted: 01-24-2019
Healthcare Representative
Lexington, KY
$13 per hour

As a Healthcare Representative, you will be responsible for maintaining the day-to-day workflow of medical claims, on-site at our partner hospitals, related to accidents associated with motor vehicle, general liability, and/or workers’ compensation, to determine available medical benefits and pursue payments on behalf of the facility. Additionally, the position is responsible for providing education and assistance with the claims’ process to patients who have been the victims of an accident.

Face-to-Face screening with the patient at bedside 25%
Contacting Auto Insurance Carriers to establish claim and get eligibility 25%
Contacting discharged patients to complete accident screening 20%
Assisting Resolution Office with status and documents collection from the hospital 10%
Data Entry / Account Documentation in CHC Case Management System 10%
Monitoring Hospital Census and ED Tracking Board for referrals 10%

• Meet with and interview patients who present to the facility Emergency Department or inpatient areas due to injuries related to accidents associated with motor vehicles, general liability and/or workers compensation.
• Educate patients on the different Auto Insurance coverage available and the Coordination of Benefits (COB) process for accident claims to assist with their medical bills from the accident.
• Ensure claims are processed in a timely manner.
• Review facility’s report to identify patients who presented to the facility outside hours or registered outside the Emergency Department area.
• Initiate calls to discharged patients to complete accident interviews.
• Create patient files for each patient visit and maintain file accuracy.
• Maintain proper account documentation in Case Management System.
• Investigate and confirm any medical coverages related to auto, general liability, and/or worker compensation insurance available to the patient, updating the patient file in the system.
• Identify any patient attorney representation and confirm patient representation with the attorney office, recording the attorney information in the patient file in the system
• Communicate with responsible insurance carriers and attorney offices to secure payment on behalf of the facility, always updating the patient file in the system
• Update patient accounts in any designated facility system(s), in accordance with the agreed upon business plan
• Process work daily for all Patient Counselor groups to ensure a consistent workflow for every patient file, to result in a reimbursement to the facility, in a timely manner
• Collaborate with facility employees in a professional and courteous manner
• Communicate any issues/concerns involving patient files or personnel to your direct supervisor

• High School Diploma or equivalent
• Bachelor’s degree preferred Business Experience:
• 2-4 years’ experience in healthcare revenue cycle or similar area
• Hospital registration/patient access experience preferred
• Property and Casualty (Auto Insurance, Workers’ Compensation) experience preferred
• Health Insurance Appeals experience preferred
• Subrogation and Coordination of Benefits experience preferred

Please submit your resume for consideration!
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