Patient Account Representative

Job Description

Job Description

Job Summary: Manages an assigned inventory of accounts receivable in such a manner as to reflect best practices expectations in healthcare revenue cycle management. These best practices are measured and monitored in order to manage performance expectations.

QUALIFICATIONS:

1. High school graduate or GED Equivalent

2. Excellent communication skills.

3. Minimum two years’ experience in accounts receivable management or accounting.

4. Working knowledge of computer system functions.

5. Strong knowledge of PC Accounting Software functions and Microsoft Applications.

6. Ability to coordinate workflow and train other employees.

ESSENTIAL DUTIES & RESPONSIBILITIES:

Core Leadership Standards & Competencies

Reviews inventory of assigned accounts, checking status of account every 10-14 days to ascertain payment status information.

Communicates with insurance companies regarding collection of accounts. This includes following up on claims submission, short payments, and appeals. At times resolves insurance coverage issues including eligibility and coordination of benefits.

Updates and notates accounts in NetSmart Avatar with all pertinent communication regarding the collection of accounts receivable.

Reviews claims for resubmission on assigned inventory of accounts for necessary payment adjustments requests..

Identifies accounts with authorization problems and communicates to appropriate staff/management for resolution.

Communicates well with insurance companies, co-workers, patients, families, and other departments with courtesy and respect.

Identifies problems in insurance coverage and brings to supervisor/manager’s attention in a timely manner.

Communicates with appropriate staff/management to resolve problems with patient responsibility (i.e. COB, pre-existing, etc.) including appeals with insurance companies to resolve delays and secure payment.

Uses a clearinghouse tool to facilitate claims submission to payers.

day shift
40 hrs/week