Patient Account Representative - Hospital

Job Description

The Patient Accounts Specialist is a liaison to review and resolve complex Patient Accounts issues. The Patient Accounts Specialist may be responsible for the customer service, posting, billing and/or collection process of the Patient Accounts process. It is the responsibility of the incumbent(s) of this position to incorporate the Mission values and philosophy of the organization into the completion of all job duties.

Relies on experience and judgment to accomplish responsibilities; works under minimal supervision; creativity is expected to perform job and may lead and direct the work of others.

• Supervision:
  Provides support and acts as a team lead over patient charge posting, billing, and collection operation; assists with work-related problems, and assists co-workers with patient account inquiries in a professional and considerate manner that promotes efficient departmental operation.
• Promotes the quality and efficiency of their own performance through participation in staff educational programs, approved continuing education courses, and specialized skill training programs.
• Provides quality training and orientation for assigned employees; informs co-workers of relevant departmental policies and procedures; allocates tasks to co-workers as needed; and implements and monitors departmental work schedules and duty assignments.
• Payor Relations:
  Promotes efficient departmental operations by monitoring controls to ensure appropriate submission, billing, and payment cycles; recommends/monitors procedures for follow-up on third party approvals, billing, and collection for overdue accounts.
• Promptly answers inquiries from patients, co-workers, and employees regarding patient accounts in a kind and courteous manner.
• Performs follow-ups on unpaid claims by contacting intermediary or insurance carrier to ensure that the patient is free from financial burden; prepares a list of past due accounts for collection to ensure that legal and payer requirements are met and the patient’s interests are appropriately represented.
• Works with insurance companies on provider contract agreements to ensure that correct adjustments to patient accounts are applied in a manner that best represents the financial interests of the patient.
• Receivables:
  Ensures implementation of established billing and collection procedures and ensures that patient accounts receivable records comply with established policies and procedures to promote quality health care services and prudent hospital management.
• Monitors accounts receivable and cash receipt functions, and keeps current on governmental third party and private insurance payer reimbursement billing procedures to ensure proper and efficient handling of patient billing procedures.
• Other duties as assigned.

• Must have 3 years of relevant experience. Bachelor’s Degree substitutes 2 years of experience. Associate’s Degree, trade school, or certification substitutes 1 year of experience. Examples of relevant experience include LPN, RN, Revenue Cycle, Accounting, Bookkeeping, Business, Billing, Coding or call center environments.
• High School or equivalent
• Knowledge of ICD-10, CPT and HCPCS coding; ability to read and understand third party payer explanation of benefits.