PRIMARY FUNCTION
Patient Account Representative is responsible for managing and monitoring all tasks and communication related to the intake of information from guarantors and/or delinquent accounts to solicit payment. Other duties include keeping records of collections and status of accounts and taking incoming and making outbound calls to assist with patient account balances.
ESSENTIAL DUTIES AND RESPONSIBILITIES
This list may not include all the duties that may be assigned.
Monitor queue to ensure calls are being handled professionally and appropriately.
Perform analysis, research, and making decisions to appropriately handle phone inquiries.
Review accounts and responsible for completing adjustments to ensure correct reimbursement as instructed by Manager.
Identify delinquent accounts, aging period, payment sources, and correct any claim processing (data entry, verification, coding and/or posting) errors identified.
Manage requests for medical records, correspondence, and/or Explanation of Benefits (EOB). Research proper processing and/or payment of accounts from patients with or without insurance.
Responsible for collection efforts and for taking the appropriate steps to have claims processed for payment (i.e., re-submitting claims or filing claims appeal for payment or additional payment).
Keeps Manager abreast of any changes, and documents any problems related to work methodology procedural and recommends actions.
Identify and resolve patient billing disputes by evaluating patients’ financial status, establishing budget payment plans, collecting payments, and refunding patient credits.
Demonstrate good judgement and read and abides by the company’s code of conduct, ethics, employee handbook, policies and procedures and other corporate mandates.
Accountable for limiting the use and disclosure of Protected Health Information (PHI) for patients and employee’s information to the Minimum Necessary to perform the job.
Other various duties as assigned, including cross training in other functional areas.
QUALIFICATIONS
EDUCATION:
EXPERIENCE:
KNOWLEDGE, SKILLS, AND ABILITIES
Knowledge of billing and collection policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.) Skill in defining problems, interpreting billing information.
TYPICAL WORKING CONDITIONS
OTHER PHYSICAL REQUIREMENTS