Patient Account Representative - Customer Service

Day (United States of America)

Patient Account Representative - Customer Service

This individual will assist and lead the Patient Accounting Representative team under guidance of the supervisor. Assist in escalated issues with patients, guarantors and third parties on accounts to resolve any questions or concerns towards satisfying account balances with patient/third party liability. Assess all options to patient’s account including payments, contracted payment plans, and financial assistance. Help create worklists and reports to identify account resolution for Patient Accounting Rep team. Help team identify any charity or financial assistance needs; all documentation and coordination with patients will be worked until determination of approval. Document all patient/ third party activity and communication in host systems.

- Minimum high school graduate or equivalent required. Associates or Bachelor’s degree from accredited institution is preferred.
- Minimum of two years experience in healthcare billing and/or business office setting, preferably in hospital billing.
- Must be able to communicate with patients effectively while maintaining customer service expectations.
- Preferred experience in Meditech and/or Athena EMR systems.
- General PC knowledge in business setting is required.
- Must have good oral and written communication skills.AUTO RECOVERY SPECIALIST  
- Establish contact with payers and follows up in accordance with established policies and procedures
- Properly executes requests for information including but not limited to COB, accident details, medical records requests
- Attempt to contact the Patient/Guarantor by using all resources when contact must be made to resolve an account with insurance, including but not limited to: contacting the NOK, PTN and the guarantor(s) employer when necessary to make contact.
- Send letters to patients based on circumstances of the account to effectively resolve the matter
- Secure any available insurance information and properly reports for billing
- Obtain crash reports after all other efforts have been exhausted including contacting patient
- Utilize E-Premis as necessary to re-print claims for insurance purposes
- Follow up with insurance companies timely to ensure payment
- Document all activity in patient accounting system with 100% efficiency and accuracy including but not limited to all conversations with insurance carriers and/or patients
- Work all system generated reminders daily keeping work lists current with no reminders older than 14 days
- Maintain knowledge and a current understanding of the PIP statute and auto related issues
- Appropriately refers accounts to be moved to SP when appropriate and consistent with policy for insurance time out
- When working accounts, also addresses physician bills for payment and settlement
- Processes requests from insurance companies timely including EOB’s, accident details
- Uses sound judgment to only pursue third party tort feasors when health insurance benefits are minimal and are not conflicting with HMO balance billing laws
- Monitor accounts to ensure timely filing deadlines are not missed due to waiting on third party information
- Ability to communicate effectively with customers
- Assist other team members and departments in completing assignments
- Comply with HIPAA regulations to ensure the confidentially and security of protected health information (PHI) when it is received, handled or shared.
- Demonstrate compliance with the Statement of Organizational Ethics and all policies related to the organization's Corporate Compliance Program as evidenced by attendance at applicable educational programs;
- consistently carrying out job responsibilities ethically and professionally;
- exhibiting ethical and professional workplace behavior and decision-making;
- reporting any infractions using the appropriate chain of command and without fear of retribution.
- Perform additional duties as assigned by management.   BILLING
- Process insurance claims in a prompt and accurate manner, meeting all corresponding performance standards.
- Demonstrates the ability to evaluate and resolve accounts by utilizing resources including, but not limited to, bills, remittances, correspondence, worklist and insurance calls in accordance to payer specific guidelines in a timely manner.
- Corrects and processes rejected and hardcopy claims in a timely manner.
- Demonstrates proficiency in the billing systems and accounts receivable systems, keeping abreast of all changes.
- Maintains current knowledge of HCPC and UB04 coding in accordance with specific insurance payer guidelines.
- Assigns appropriate date to follow up with insurance carrier to ensure prompt payment.
- Updates billing and registration systems with any demographic/insu