PT ACCOUNT REP I-CLINIC

Perinatal Overview: Fort Sanders Perinatal Center, part of Covenant Health, specializes in caring for women with high-risk pregnancies. For more than 25 years, the center has provided expert guidance and advanced services for complex conditions such as multiples, maternal age, diabetes, hypertension, and infertility-related pregnancies. With locations in Knoxville, Morristown, and Sevierville, the team is dedicated to helping families make informed decisions and ensuring the safest possible outcomes for mothers and babies.

Position Summary: This position will be responsible for all aspects of the insurance and billing process.

Responsibilities: Reviews medical records to ensure that ICD-9 and CPT codes are used in accordance with coding and reimbursement guidelines. Ensures that charges for all services are captured. Posts office and hospital charges. Files claims to insurance companies. Sends statements to patients. Posts personal, insurance and collection agency payments. Follows-up with insurance companies regarding unpaid claims. Reviews credit balance accounts and generates refunds when appropriate. Reviews delinquent accounts and conducts collection activities including letters, phone calls and turn-over to collection agencies when appropriate. Conducts in-office collection activities including reviewing accounts prior to office visits, establishing delivery contracts with patients, explaining accounts to patients and setting up payment plans. Responds to patients’ phone calls regarding billing questions. Completes insurance company credentialing paperwork for provider participation. Serves as a back-up for all clerical positions. Performs other duties as assigned to the satisfaction of the department manager. Qualifications Minimum Education 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. Minimum Experience Experience in medical billing or financial area required. Strong knowledge of medical terminology preferred. Must be familiar with insurance plans and requirements and collection practices. Licensure Requirement None