Lead Account Representative Patient Accounts Full Time

Cost Center

923 Patient Accounts

Scheduled Weekly Hours

40

Work Shift

First Shift (United States of America)

Shift & Status

Who Are We?

We at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers who witness the impact of our life-changing work each day.

Each day, we are closing the gaps in access to care. We are innovating through leading-edge research, testing, programs, and treatment modalities that others replicate across the country. Our services include a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day programs), assessment and testing, residential, addiction treatment and specialty services such as crisis response, employee assistance programs, forensic psychiatry and psychology, and neuromodulation. On-the-job educational programs for nurses, psychologists, advanced practice providers, psychiatrists, and chaplains are equipping the next generation of care providers.

We are passionate about serving and are honored to be a part of this incredible work.

What Will you Do?

As a Lead Account Representative at Pine Rest, you’ll be part of tight-knit team that believes in the healing power of your expertise and compassion. According to general directives and established departmental and or Pine Rest Christian Mental Health Services policies and procedures, independently performs administrative duties related to billing, collection, accounts payable, accounting, and customer assistance.  The Account Representative must demonstrate excellent customer service and have enthusiasm about the program and the Pine Rest organization.

Principal Duties and Responsibilities:

• Responsible for a variety of tasks in the department.  May input data, monitor and run reports, process checks, balance information, verify information, file, sort, and send bills.

• Submit claims to payers assuring claims meet the clean claim definition to assure timely and accurate payment.

• Contact insurance companies to obtain preauthorization (in some departments), resolve outstanding balances, incorrect payments, claim denials or information needed to adjudicate claims. Work with clinical areas to resolve rejections and determine collectability or need for adjustment. Process payment/claim resolution documents, making determinations on balances based on contractual arrangements and insurance coverage.

• Apply insurance and patient payments to accounts, monitoring for compliance with contractual agreements to assure appropriate reimbursement for services provided.  Prepare and balance bank deposits.

• Answer patient questions regarding balances, make referrals to other areas as appropriate, i.e. clinical area, Patient Rights, etc.  Create and maintain customer-friendly environment with internal and external customers.

• Establish payment arrangements within established guidelines.

• Review accounts to determine patient delinquency and initiate collection steps or refer to collection agency.  Coordinate accounts and balances with collection agency.

• Responsible for the monitoring and careful use of resources impacting them in a moderate capacity (i.e. Balance cash drawer, cut checks, effective use of time).

• Maintain knowledge of payer regulations, contracts and billing requirements and act as a resource to clinical sites regarding these requirements.

• Creates training materials and trains new staff members.

• Assist Manager in creating documented department procedures and job aids.

• Mentors Customer Service and Cash Posting staff on problem resolution as needed.

• Assist Customer Service staff with challenging patient calls.

• May attend staff meetings

• May support and promote a recovery focused environment and person-centered approach within the program.

What Does the Role Require?

Education/Experience:

• Work requires the ability to read, understand and follow directions, and do computations at a level typically acquired in high school or equivalent.  An Associate’s Degree or equivalent knowledge, skills, and abilities may be required.

• Requires minimum experience of three months in related field.

Benefits:

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