The Patient Account Representative reports directly to the Billing Manager. Under general supervision, may participate in any or all aspects of the patient processing and accounts receivable functions of the organization including billing, charge entry, collection, registration, scheduling, follow-up, coding, payment posting and credit balance resolution. May balance monthly transactions and provide summaries to department administration. They will have detailed knowledge of the Functions within the Revenue Cycle and how they interact in the life of a patient account.
DUTIES AND RESPONSIBILITIES
· Identifies problem accounts with payors; investigates and correct errors follow-up on missing account information, and resolves past-due accounts.
· Performs various collection actions including contacting patient by phone, correcting, and resubmitting claim to third party payers.
· Prepares reviews and send patient statements.
· Answers inquires by phone regarding past-due accounts and insurance guidelines.
· Handles inbound patient, insurance company, and internal calls regarding billing inquiries, customer complaints, and eligibility.
· Processes credit card payments.
· Independently maintains uninsured work queue for assigned accounts.
· Accurately posts insurance remittance and patient payments.
· Follows internal policies and procedures for payment posting guidelines relating to payer fee schedule.
· Transfers bills to secondary or tertiary accounts, if applicable.
· Posts adjustment and write offs to appropriate accounts.
· Prepares reports to identify and resolve accounts receivable.
· Monitors aging reports and take such steps as necessary to guarantee payments of claims.
· Make adjustment to either patient or practice accounts based on internal reports and/or documentation.
· Ability to read and understand different Explanation of Benefits.
· Keeps supervisor informed of areas of concern and problems identified.
· Contacts agency representative to verify type and extent insurance coverage.
· Accepts assignments from management and maintain open communication with their manager to resolve quality and production issues.
· Assists with yearly financial audit.
· Maintains strict confidentiality regarding confidential conversations, documents and files.
· Participates in educational activities and attends monthly staff meetings.
· Adheres to all HIPAA guidelines/regulations.
· Performs other duties as assigned.
· High School diploma or GED required/Associates' degree preferred.
· Understanding of payer EOBs/Remits.
· Strong computer skills including Microsoft Word, Excel, and fast and accurate typing skills.
· Minimum of 2-4 years of experience using ICD-9-CM, Volumes 1- 3, CPT, HCPCS, and IHS coding conventions.
KNOWLEDGE & EXPERIENCE REQUIRED BY THE POSITION
· Must demonstrate ability to work independently with minimum supervision in a team-oriented environment and interrelate well with individuals with diverse ethnic and cultural backgrounds and needs.
· Advance knowledge of medical codes involving selections of most accurate and description code.
· Excellent oral, written, and telephone communication skills.
· Working knowledge of rules and regulation pertaining to the FQHC guidelines.
· Ability to prioritize and manage multiple tasks with efficiency in dealing with multiple facilities.
· Ability to handle a large volume of project receiving and researching claims.
· Excellent computer skills, including Excel, Microsoft Word, etc.