Patient Account Representative

Provide patient account services to include, but not limited to, verifying patient insurance benefits/eligibility, create financial charts, obtain required patient signatures and update logs. Assist with payment collections, post physician charges and other designated administrative tasks. 

Essential Functions:

• Have a good understanding regarding UB-04 and CMS 1500 claim forms, bill type, revenue codes, condition codes, etc. 
• Ability to determine if claims are paid at correct contracted rates based on length of stay and authorized days.
•  Proficient in reading and understanding of explanation of benefits.
• Verify and document detailed patient insurance benefit and eligibility information in HMS, logs and in financial charts for all inpatient and outpatient services.
• Verify eligibility for all Medicare patients and printout eligibility inquiry.
• Post physician charges into MedHost and keep physician logs updated as applicable.
• Alert Business Office Director of all benefit eligibility matters that suggest or challenge reimbursement.
• Create financial charts for each inpatient and/or outpatient admission.
• Obtain required patient signatures/data for all services.
• Collect patient payments as identified. All collected payments must be logged in the designated tracking tools and reconciled.
• Assist the Business Office by obtaining insurance claim status for unpaid claims when assigned to a claim status project.
• Complete adjustment forms for any charity or administrative adjustments for approval.
• Update on a daily basis the upfront collection log, charity log, and administrative adjustment log. Review with BOD on a weekly basis.
• Ability to check in/register patients when needed to include financial counseling, payment collections, etc. Provide information to the patients regarding their benefits and financial obligations.
• Perform other functions and tasks as assigned.

Educations/Skills/Requirements:

• High school diploma or equivalent required.
• Two years prior admissions and/or collections experience in a hospital setting required, psychiatric experience preferred.
• Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.
• Knowledge of office administration procedures with the ability to operate most standard office equipment.
• Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.
• Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.
• Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.
• Self-motivated with strong organizational skills and superior attention to detail.
• Must be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes.
• Capable of working within established policies, procedures and practices prescribed by the organization.
• English sufficient to provide and receive instructions/directions.