Patient Account Rep (4604)
|Salary Range:||$14.58 minimum|
|Employment Type:||Full Time|
|Description:||Responsible for working claims from start to finish to fully support the patients’ needs. Maintains A/R at acceptable aging levels by prompt follow-up of unpaid claims, denied claims and underpaid claims. Provide information over the phone for all patients billing questions directed to the central business office. Review all credit balances for possible refunds. Perform all duties in a manner which promotes team concept and reflects the clinic’s mission and philosophy.|
|Duties:||Answer calls and responds to patient inquiries and/or problems regarding bills in an accurate, prompt, and courteous manner.|
Identify delinquent accounts and contact patients to negotiate a payment plan.
Respond to collection agency correspondences and agency assignment paperwork.
May review returned mail to skip trace.
Thoroughly and timely work accounts in work queues as defined by Policies and Procedures.
Respond to any correspondence attached to patient statements.
Process bankruptcy and probate accounts.
Evaluate patient eligibility for financial assistance adjustment.
Receive patient requests for information and adjustments. Initiates resolution as identified in department policies and procedures.
Post all insurance payments in a timely and accurate manner.
Post all insurance denials in a timely and accurate manner.
May process the insurance claims correspondence and mail return.
Read and interpret EOB’s (Explanation of Benefits)
Provide quality customer service and resolution to callers’ concerns in a brief manner.
Process appropriate refund in accordance with department policies and procedures.
Present unresolved patient concerns to the Team Lead for resolution immediately with related documentation.
Document account activity accurately and promptly during or immediately following each patient encounter on the telephone or in person.
Responsible for the accurate and timely submission of claims, denials, appeals and re-bills of insurance claims.
Responsible for the analysis and necessary corrections of patient accounts as it pertains to clean claim submissions, re-bills or appeals.
Responsible for maintaining work queues.
Responsible for identifying potential errors that require necessary coding reviews, corrections or adjustments.
Responsible for telephone and/or written correspondence with insurance companies for claims follow up.
Responsible for correctly identifying and updating various types of insurance entry information.
Maintain basic understanding and knowledge of health insurance plans, policies and procedures.
Make suggestions on improving Clinic procedures to improve billing accuracy and collections.
|Qualifications:||High school diploma or equivalent.|
Minimum of 1-3 years experience in health care accounting within a medical office.
Knowledge of private billing and collections regulations experience preferred.
Demonstrated knowledge in balancing and explaining account balances.
Must be a proactive problem solver, foster teamwork and trust, be highly skilled in prioritizing, organizing, planning, communication and staying on track.
Demonstrated customer service expertise.
Knowledge of commercial insurance contract practices, third party billing and billing to private clients required.
Keyboarding minimum 40 wpm.
Accurate 10 key by touch and familiarity with Microsoft Word and Excel.
Excellent organizational skills required.
Must be able to work in a highly demanding atmosphere, with a variety of personalities within a fast paced environment.
Excellent verbal and written communication skills, and extensive hands-on computer background.
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