Patient Account Representative

Business Office:
Patient Account Representative

Essential Functions:

1) Manage work queues, aging reports and claim correspondence to ensure accurate and timely processing of claims and proactively work to reduce overall account receivables (AR) by meeting or exceeding monthly reduction targets through timely follow-up, claim resolution and payer communication.

2) Review aging accounts to identify outstanding patient balances, initializing appropriate collection procedures in accordance with established guidelines

3) Educate patients on financial policies and procedures, including payment expectation and available assistance programs, and screen patients for eligibility for charity care to support equitable access to healthcare services.

4) Completing financial applications within 30 days of receipt from the patient, ensuring timely processing and eligibility determination for charity care.

5) Provide exceptional customer services by addressing patient and insurance inquiries professionally and promptly, ensuring clear communication, issue resolution and a positive experience throughout the revenue cycle process.

6) Collaborate with billing specialist to submit claim reconsiderations and appeals in a timely manner, ensuring accurate documentation and adherence to payer-specific guidelines to support the successful reimbursement outcomes.

7) Consistently meet or exceed departmental productivity goals and key performance indicators (KPI) benchmarks, contributing to efficient operations, timely account resolution and overall revenue cycle success.

8) Verify the validity of account balances by researching and reviewing payment and adjustment history, ensuring accuracy and completeness. 

9) Responds to all messages and emails received before 3pm by the end of the business day, ensuring timely communication and maintaining high standards of customer service and operational efficiency.

10)Adhere to HIPPA regulations to protect patient confidentiality and information security.

11) Demonstrates knowledge of departmental responsibilities during emergent alarms, knowledge and whereabouts of department manuals. 

12) Performs other duties as assigned. 

Qualifications:
Knowledge, Skills, and Abilities:        
Ability to read, spell and write clearly.  Accurate typing, filing and calculating skills.  Skills in performing Excel and Word functions.  Communication and computer skills.        
Education:        
High School graduate with accounting courses.        
Experience:        
Experience in working with the public, preferably in the medical environment. Knowledge of the Fair Debt Collection Act.  Experience in office procedures, preferably in the medical environment.         
Certification/Licensure:        
None.        
Code Blue Training:        
Ability to activate Code Blue system by dialing 200.        

Physical Demands:
May require constant sitting, Requires occasional standing and walking.  Occasionally lifts and carries up to 30 lbs.  May require pushing and pulling up to 30 lbs.  Eye-hand coordination, and finger and manual dexterity are required.  Requires corrected hearing and vision to normal range.  Requires working under stressful conditions.  Some exposure to communicable diseases and hazardous materials is required.  Requires occasional bending, twisting, climbing, balancing, stooping and kneeling. Occasional reaching and overhead work are required.  Requires occasional grasping.  Requires the ability to distinguish letters or symbols.  Ability to use office equipment such as computer terminal (PC), typewriter, telephone, copier, and fax machine.        

Working Conditions:
Primarily Monday thru Friday on a scheduled shift.  Weekend work and overtime may be required.