Patient Account Representative - Patient Financial Services

Employment Type

: Full-Time


: Miscellaneous

* Job Objective: A brief overview of the position. * Works under the direction of the Patient Financial Service Manager. Is engaged in activities relating to the collection of payment and/or resolution of self-pay balance accounts. * Reports to * Patient Financial Service Manager * Supervises * None * Ages of Patients * None * Blood Borne Pathogens * Minimal/ No Potential * Qualifications * Education * Preferred: Some college preferred * Licensure/Certification * None * Experience * Required: One year prior experience in a hospital setting or billing certification; Experience in a clinic, payer or collection agency setting may be substituted. Must have working knowledge of managed care, Medicare/Medi-Cal Billing regulations. * Essential Responsibilities * Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations. * Manages new accounts, on a daily basis, by working within Receivables Workstation. Interfaces with other departments within the hospital, when appropriate, to obtain information necessary to process or resolve claims. Contacts patient and/or account guarantor to solicit payment on account. * Works all accounts listed in the Follow-Up cue, on a daily basis to promote collection of accounts. This will include telephoning the payer or identifying the claim on the payers' Internet websites. * Manages entire account inventory on a timely basis to promote payment and resolution of all accounts as instructed by management. * Responsible for staying current on all payer requirements by reading bulletins, reviewing provider handbooks, accessing websites, etc. * Process incoming correspondence, including signature letters, denials, prior authorizations and additional information necessary to process the claim. * Records newly identified insurance plans and facilitate the account processing of new plan in accordance with pre-billing policies and procedures. * Records accurate and definitive notes in the electronic account file that depict the current status of account, issues with account and anticipated date of resolution. * Escalates account management to Supervisor when extraordinary issues arise. * Assigns a status codes to each worked account to enable account tracking, statistical data gathering and audit activities. * Manages new credit balance accounts every day and prepares adjustments or refunds to zero the account balance. * Handle special projects as directed by management e.g. high dollar accounts, accounts over 180 days old, etc. * Performs other duties as assigned

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