Patient Accounts Rep

Job Accountabilities

• Attending seminars, as needed.
• Complete inquiry forms accurately and completely to expedite account resolution.
• Correct any errors promptly and accurately.
• Correct any errors promptly and have the claim resubmitted if needed.
• Displays professional commitment and supports the unit team by promoting unity and teamwork among coworkers by maintaining a positive attitude and positive working relationships.
• Handle incoming correspondence and returned mail on a timely basis.
• Identify late charges, obtain supporting documentation, update contractual adjustment on the account and have a corrected claim submitted to the insurance carrier in a timely manner.
• Maintain accurate and complete notes on the patient account note area within the current computer system.
• Maintain productivity report for accounts within assigned responsibility and submit to Customer Service Manager weekly or as requested.
• Meet or exceed productivity and monthly cash collection goals as assigned by Customer Service Manager.
• Negotiate payment arrangements.
• Obtain a completed charity application with all required documents from patients that apply for charity or our discount program.
• Obtain all necessary documentation from patient, insurance company, or third payer intermediary to ensure all accounts are being resolved according to established hospital guidelines.
• Obtain approvals per procedure guidelines for any adjustments.
• Prepare refund request and obtain supporting documentation for credit balance resolution per established guidelines.
• Prepare request form for account write-off or agency referral after appropriate follow-up activity has been performed and refer to Customer Service Manager or other assigned personnel for approval.
• Reduce outstanding dollars and number of accounts on a consistent basis.
• Report all collection and follow-up activities daily as requested by the Customer Service Manager.
• Resolve accounts within assigned responsibility per Account Receivables Summary Report using procedure guidelines (collection work list).
• Screen patients for potential Medi-Cal coverage or charity write-off, if not able to negotiate payment arrangements.
• Send appropriate form letters when necessary.
• Submit transactions (adjustments) as required to maintain an accurate patient account record on the computer system.
• Telephone patient/guarantor, insurance company or third-party intermediary to resolve account balances.
• Use the telephone as a primary tool in effective collection/follow-up activity.
• Verify the accuracy of the insurance payments and patient responsibility as stated in the Explanation of Benefits (EOB).

Job Qualifications

• Education Req: High School or equivalent
• Work Experience Req: Experience With Chart Maxx Or Other Scanning Systems. Experience with Quadra Med/Affinity or other patient accounting software. 2-3 years' Experience in a health care environment. Experience with Insurance (UB04) billing regulations; and electronic claims submission.
• Knowledge, Skills And Abilities Req: Must be able to operate 10-key calculator, type a minimum of 40 words per minute and other business machine operation experience. Must present a professional image to patients and the community through telephone, personal contact, and/or written correspondence. Responsible to perform, understand and demonstrate ability of all courses designated, within 90 days of hire for new employees and within 1 year of 2/12/2018 for current employees. Current employees must successfully pass a competency test every two years from the original date completed.
• Knowledge, Skills And Abilities Pref: Knowledge of fair credit and collection practices. Understanding of PPO/HMO and commercial insurance benefits and billing requirements.
• Licenses/Certifications Pref: Certified Patient Account Technician certificate.

Pay

The hourly salary rate range for this position is $21.00 - $24.37.