Patient Account Representative

Essential Duties & Responsibilities

• Ensure delivery of excellent customer service through communication and coordinating with team or other departments to resolve issues.
• Handle incoming calls from patients with questions regarding their statement, EOB’s and/or services received at Altus facilities; process patient refunds, process and review account adjustments.
• Conduct incoming and outgoing Tier One collection calls to check on claim status and render payment from insurance companies, patients, vendors and responsible parties.
• Conduct routine audits on medical records process to ensure any and all compliance rules are met.
• Ensure that all accounts are worked timely and documentation is kept up to date.
• Negotiate payment plans according to specified guidelines.
• Responsible for fielding complaints about facility/clinical care, standards as well as HIPAA, red flag rules, and other problems that patients may have. Must record complaints and forward to appropriate manager.
• Follow up with patients to ensure that appropriate changes were made to resolve customers’ complaints or issues.
• Responsible for monitoring and running daily and monthly reports on assigned facilities to ensure balance is due to patient’s in-network Emergency Room benefits and update account status.
• Responsible for completing patient, physician, and any other medical records requests.
• Perform other duties as assigned.

Safety/Infection Control

• Demonstrate knowledge of and adhere to regulations and Emergency Center policies and procedures pertaining to safety, emergency preparedness, infection control, OSHA, fire safety and hazardous materials.

Performance Improvement

• Participate in performance improvement activities as necessary

Customer Service

• Maintain confidentiality of patient related issues and adhering to all HIPAA rules and regulations.
• Demonstrate effective interpersonal skills
• Treat all patients, visitors, and staff members fairly and with respect
• Utilize effective communication methods and skills
• Explain all procedures, treatments, and care while remaining aware of language barriers
• Able to perform care in non-judgmental manner and recognize discrepancies between patient and personal beliefs

Emergency Center Policy

• Ensure personal appearance is business casual and professional at all times
• Responsible for wearing Emergency Center identification badge at all times which must be visible and above the waistline
• Attend all required meetings and in-service education
• Remain flexible in staffing patterns and resolution of staffing conflicts; participates in temporary assignments
• Compliance with attendance standards
• Demonstrate flexibility when changes in assignments are necessary

Qualifications

• EDUCATION & EXPERIENCE:
• High school diploma required
• 3-4 years customer service experience a must
• 1-2 years experience in medical billing
• 1-2 years of experience medical insurance collections
• Excellent communication skills with internal and external clients.
• LANGUAGE/MATH/REASONING ABILITY:
• Ability to read, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
• Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public
• Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization
• Ability to add and subtract two digit numbers and to multiply and divide with 10's and 100's.
• Ability to perform these operations using units of American money and weight measurement, volume, and distance
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations
• CERTIFICATE/LICENSES:
• None

Competencies

• Professional Maturity: The ability to separate emotional feelings from the real issues at hand
• Responsibility: The ability to accept choices you have made and the results they have led to
• Communication: The ability to write and speak effectively; actively listens to others, and give feedback
• Flexibility: Demonstrate responsiveness and adaptability following change initiatives
• Intelligence: Understand information and apply new knowledge
• Energetic: Exhibits high levels of energy and enthusiasm
• Organized: Efficient in structuring tasks to be accomplished
• Computer Savvy: The ability to use technology efficiently and effectively
• Customer Service: The ability to enhance customer satisfaction
• Job Knowledge/Technical Knowledge: Knowledgeable of current role and technical systems, and the impact it has on the organization
• Integrity and Respect: Demonstrates upmost level of integrity
• Interpersonal Communication: Writes and speaks effectively based on the psychological, relational, situation, environmental and cultural dynamics within the situation
• Collaboration and Partnership: Encourages participation from team members
• Manages Change: Demonstrates flexibility with changing environments
• Problem Solving: Resolve issues in a timely manner
• Attention to Detail: Follows procedures to ensure entry of data
• Organization: Uses time efficiently by prioritizing and planning work activities
• Judgment: Ability to make independent decisions
• Teamwork: Works with others to accomplish objectives and shows support for decisions
• Quality: Sets high standards to ensure quality in work performed
• Accountability: Takes responsibility for adhering to all company policies, procures, and performance expectations

Physical Demands

• The physical demands for this position include: adequate vision, hearing, and repetitive motion
• Light physical activity performing non-strenuous daily activities of an administrative nature
• Ancending or descending stairs, ramps and the like, using feet and legs and/or hands and arms
• Substantial movements (motion) of the wrist, hands, and/or fingers in a repetitive manner
• Bending legs downward and forward by bending leg and spine

Work Environment

• Well-lighted, heated and/or air-conditioned indoor office setting with adequate ventilation