Patient Services Representative

Your experience matters 

Ottumwa Regional Physicians Admin is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Patient Services Representative joining our team, you’re embracing a vital mission dedicated to making communities healthier®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

Why join us

Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers:  

• Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
• Competitive Paid Time Off 
• Employee Assistance Program – mental, physical, and financial wellness assistance
• Tuition Reimbursement/Assistance for qualified applicants
• And much more...

What we’re looking for

A Patient Services Representative is responsible for completing insurance claims for patient services, follow-up on the claims to ensure payment is made promptly and accurately. Ensure Medicare rejections from IVANS are worked daily and rekeyed via DDE system. Maintains knowledge of CMS billing rules and regulations. Responsible for complex billing issues. Manage Medicare Bad Debt Log. Manage Patient Financial Services Denial Log. Responsible for primary Medicare First Level Appeal Submission after approval from PFSD.

How you’ll contribute 

• Ensure the collection of funds for all hospital billable services so that goals are met in Bad Debts, AR Days and Cash collections

• Support the Director of Patient Accounting to maximize the income earned through cash management

• Maintain accuracy in claims processing paper and electronic claims

• Maintain follow-up on accounts to ensure claims are paid promptly and correctly

• Explain patient inquiries regarding hospital charges, insurance payments or insurance coverage

• Develop a relationship with third party payers, and venders to ensure cash flow is maximized

• Inquire and seek explanations for all denials and/or rejections
  Adhere to standards set forth by Health Insurance Portability and Accountability Act (HIPAA) of 1996

• Ensure Medicare rejections from IVANS are worked daily and rekeyed via DDE system

• Maintains knowledge of CMS billing rules and regulations

• Responsible for complex billing issues

• Managed Medicare Bad Debt Log for Monthly submission: Review Medicaid remits daily for Medicare qualifying accounts and PFSD will give agency returns for account review of accounts > 120 for logging

• Manage Patient Financial Services Denial Log

• Responsible for primary Medicare First Level Appeal Submission after approval from PFSD

Qualifications & Requirements:

• Education: Minimum Education High school diploma, Associate’s degree or higher preferred

• Minimum of 4 years in Insurance Billing/ Follow up required

• Coding experience preferred

Schedule: PRN – As Needed 

EEOC Statement

Ottumwa Regional Physicians Admin is an Equal Opportunity Employer. Ottumwa Regional Physicians Admin is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.