Patient Account Rep - Government Programs (Managed Medi-Cal) FT Days

Under general supervision, the Patient Account Rep oversees collection of patient revenues, maximizing reimbursements, cash flow and maintaining low receivables, while also maintaining compliance with established state and federal regulations.

Core Competencies

• Reviews status of work queues and prioritizes job functions to ensure timely follow-up on patient accounts.
  
  
• Reviews patient accounts and follow-up documents to determine the nature and extent of delinquency problems, and any actions taken by patients or third party payers; investigates delinquency cases to identify any special circumstances affecting payment delays
  
  
• Identifies and resolves problem issues independently..
  
  
• Receives and answers inquiries from patients and insurance companies regarding charges and/or billing discrepancies

• Stays informed of updated insurance requirements and reimbursement practices.
  
  
• Assists with training of new staff members
  
  
• Promotes positive customer relations.
  
  
• Compiles and submits for approval the supporting documentation for accounts to be granted a charity allowance or referred to an outside collection agency for further collection action..
  
  
• Adjusts and rebills claims electronically or by paper to payers as required.

• Processes appeal requests to insurance payer by obtaining complete medical records and completing required payer appeal forms.

• Updates and corrects demographics, insurance and financial changes necessary to maintain accurate account information..
  
  
• Updates and corrects demographics, insurance and financial changes necessary to maintain accurate account information..
  
  

 

Education

DegreeProgramHigh School Diploma/GED or Higher EducationGeneral Studies
Compensation Range
$22.55 - 32.87 / Hour