Patient Account Representative II - Rev Cycle

Position Summary

The patient account representative is responsible for the timely collection of third party and private pay receivables within regulatory guidelines. The Patient Account Representative II role centers on the back-end functions of the revenue cycle, covering the full spectrum of patient accounting services. It places a strong emphasis on insurance follow-up and denials resolution as core areas of specialization.

Key Accountabilities

• Manage multiple work queues for follow-up and denials by engaging payor websites and initiating calls to ensure prompt payment of medical claims.
• Reviews incoming correspondence and takes appropriate action.
• Responds promptly to inquiries.
• Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments.
• Pursues appeals and takes the necessary steps to bring accounts to resolution.
• Analyzes accounts for errors, adjustments, and credits, issuing corrected entries when necessary.
• Updates account information accordingly.
• Communication documentation demonstrates clear action taken on each account as well as what further action is needed to capture payment.
• Work output is documented clearly, so that various departments involved in resolution can review the account.
• Able to meet departmental standard for quality and productivity.

Certification/Skills

• Basic knowledge of business office, patient billing, or collection/reimbursement procedures in a healthcare setting.
• Proficient in MS Office with emphasis in Excel, 10-key and math.

Requirements

• Minimum Education: High School Diploma or equivalent.
• Minimum Experience: Three years hospital/medical collections experience with understanding of third party reimbursement procedures, as well as state and federal regulations governing healthcare.

Physical Requirements

• Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive

This position is a security-sensitive position pursuant to Texas Education Code 51.215 and Texas Government Code 411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code 117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position.

Residency Requirement

Employees must permanently reside and work in the State of Texas.