Patient Account Representative Job Description

Position: Healthcare Patient Account Representative

Location: South Central Clinics

Department: Ancillary Services 

Reports To: Clinic Director

 

Summary:

The Healthcare Patient Account Representative is responsible for managing patient accounts, billing, and collections. This role involves interacting with patients to resolve billing inquiries, process payments, and ensure accurate and timely billing submissions. The ideal candidate will have strong analytical skills, attention to detail, and excellent communication abilities to provide outstanding customer service while adhering to healthcare regulations and policies.

Key Responsibilities:

Billing and Claims Processing: Generate and submit accurate and timely insurance claims to third-party payers. Review billing codes, patient demographics, and insurance information for accuracy. Follow up on unpaid claims, denials, and appeals to ensure maximum reimbursement. Patient Account Management: Maintain patient accounts, including posting charges, payments, and adjustments. Review patient account balances and contact patients regarding outstanding balances or payment arrangements. Assist patients with billing inquiries, insurance coverage questions, and payment options. Payment Processing: Process payments, refunds, and adjustments accurately using billing software. Reconcile daily deposits and prepare bank deposits as necessary. Monitor and report on accounts receivable aging and collections activities. Customer Service: Provide excellent customer service to patients, insurance companies, and other stakeholders. Address patient concerns, complaints, and inquiries in a professional and empathetic manner. Educate patients on billing processes, insurance benefits, and financial assistance programs. Documentation and Reporting: Maintain accurate and detailed records of all account activities and communications. Generate reports on billing, collections, and account receivables for management review. Assist in identifying trends, issues, and areas for improvement in revenue cycle processes. Compliance and Regulations: Adhere to healthcare regulations, compliance standards, and billing guidelines. Stay updated on changes in healthcare laws, insurance regulations, and coding practices. Ensure patient confidentiality and data security in accordance with HIPAA regulations.

Qualifications:

High School Diploma or equivalent; Associate’s or Bachelor’s degree preferred. Previous experience in healthcare billing, collections, or revenue cycle management. Knowledge of medical billing codes (CPT, ICD-10), insurance claims processing, and healthcare reimbursement methodologies. Proficiency in using billing software, electronic health record (EHR) systems, and Microsoft Office Suite. Strong analytical, problem-solving, and organizational skills. Excellent communication and interpersonal abilities.

Physical Requirements:

Ability to sit for extended periods and operate a computer. Manual dexterity to use a keyboard and navigate software applications. Vision and auditory skills to review documents, communicate with stakeholders, and conduct phone conversations.