The Patient Accounts Representative is responsible for providing various support within the Medical (Hospital Centralized Business) Billing Department. This position involves collecting and managing accounts, following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims when appropriate, assisting in posting cash, adjustments and customer service support.  This position will assist as needed all teams within the Business Office to help overall operations and revenue optimization.

 

Job Responsibilities

 

·Posts payments and reconciles account balances

·Processes patient and insurance refunds

·Reviews open accounts for account reconciliation and next steps to resolve open balances

·Contacts patients and insurance carriers as needed to resolve open balances and account issues

·Reviews claims and bill scrubber edits to ensure claims are billed and submitted appropriately

·Communicates with ancillary departments and agencies regarding account errors, billing edits, denials and charge issues

·Reviews payments for accuracy and appropriate account distribution

·References contracts for payment and balance accuracy

·Answers calls as needed and provides support to customer service.

·Responds to correspondence and emails timely and with accuracy

·Posts adjustments as needed and directed to resolve open balances

·Reviews and works denials as needed, updates and drafts appeals as needed to carriers to resolve open account balances

·Reviews open AR to identify and resolve accounts receivable as well as escalates issues as needed.

·Composes and types routine correspondence, memos, letters, etc

·Responsible for updating the patient accounts' system with information and notes as needed.

· Performs other duties as assigned by management

· Responsible for timely completion of projects and tasks as assigned by management and feedback on outcomes

 

 

Education, Training, Licensure and Experience Requirements

 

Minimum Education: High School or GED required

Minimum Experience:

2–5 years previous Hospital business office experience required

Ability to type 45wpm

Medical terminology required

Ability to use basic office equipment and Knowledge of CTR computer terminals a plus.

 

 

Essential Physical Requirements

 

Must be able to sit for extended periods of time (3-4hrs). Must be capable of hands and eye coordination. Must be physically able to lift, stand, bend, stoop and walk short distances

 

Exposure to Hazards

 

May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital's SDS (Safety Data Sheet) database and accessed through the hospital's Intranet site (Employee Tools/SDS Access). A copy of the SDS database can also be found at the hospital switchboard, saved on a disc.