Patient Account Representative

Duties And Essential Job Functions

• Work accounts receivable assignments efficiently and timely while maintaining expected performance goals.
• Identify problem accounts with payers by investigating, analyzing, and correcting errors.
• Conduct follow up on outstanding accounts by calling insurance companies or utilizing the payer web portals.
• Properly documents detail notes on every account preparing for the next course of action and or resolution.
• Research denied claims as well as underpayments from third party payers and processes appeals and/or claim(s) reconsiderations to insurance companies in a timely manner.
• Ability to identify trends and repeated problems and report them to management for evaluation.
• Process patient payments and refunds.
• Work with insurance companies to determine benefits for procedures, surgeries, and clinic services in order to estimate patient’s financial responsibility.
• Ability to analyze and understand written communication from insurance companies and other third parties, including but not limited to, explanation of benefits, correspondence, and requests for additional information to process claim(s) in a timely and accurate manner.
• Contact patients and collects prepayments and outstanding balances.
• Interacts with patients when eligibility and benefits cannot be verified through the various payer portals, etc.
• Interacts with patients to assess eligibility for financial assistance programs/grants and assists them with the application process(es).
• As appropriate, obtains prepayment(s)/payment arrangement(s) for patients receiving cancer therapy, other USA services, and outstanding balances.

Qualifications

• High school diploma or general education degree (GED) and one (1) year related experience in a medical office or hospital setting with experience processing professional fee claims.
• PREFERRED: CPT-Coding/Billing, Continuing Education Coding classes
• Knowledge of medical terminology and office billing.
• Knowledge of electronic medical records (EMR), patient management (PM) system(s), insurance payer portals, and clearinghouse(s) is necessary to utilize these resources to work assigned tasks and responsibilities effectively.