Patient Account Representative

JOB SUMMARY: The Patient Account Representative is responsible for the follow-up and denial management as necessary for final resolution. Responsible to identify the various types of diagnosis and procedures codes (ICD10, CPT, HCPCS, DRG) as they relate to reimbursement. Communicates clearly and efficiently by phone and in person with clients and staff members. Maintains productivity standards and reports. Obtains updated demographic information and all necessary information needed to comply with the various Government Programs billing requirements. Operates computer to input follow up notes and retrieve collection and patient information. Maintains proficiency in Medical Terminology.

EDUCATION, EXPERIENCE, TRAINING

1. Previous Billing Experience within a hospital Business Office Required.
2. Previous experience with government programs and collections preferred.
3. Knowledge of medical terminology.
4. Effective written and verbal communication skills.
5. Ability to multi-task, prioritize needs to meet required timelines.
6. Analytical and problem-solving skills.
7. Customer Services experience required.
8. High School Graduate or GED Equivalent Required.

DUTIES AND RESPONSIBILITIES
1. Is able to bill all payers including Medicaid and/or Medicare claims via the Emdeon and/or DDE Billing system in an accurate and timely manner, complying with the standard UB04 requirements and within the facility standard.
2. Modifies all required fields on the billing forms as necessary to avoid delay in payment.
3. Notifies billing supervisor of any deficiencies in the charging, coding and billing process.
4. Attaches all necessary forms to billing (authorizations, first reports, discharge summary,
Implants etc.) and/or makes supervisor aware of lack thereof.
5. Performs quality assurance as a second check point for accuracy of all codes and
financial classes and verifies insurance addresses, when in questioned.
6. Documents all billing, collections and follow up activity appropriately in patient billing system.
7. Modifies billings as required with regard to specific agreements the facility may have
with various payers/carriers.
8. Uses accurate payer codes and financial classes.
9. Works accounts as assigned both expediently and thoroughly to expedite payment and
final disposition of account.
10. Communicates effectively with patients, and other payers to facilitate payment in a
timely fashion.
11. Performs special projects and assignments in an accurate, efficient, and thorough
manner.
12. Maintains regular attendance.
13. Performs all other duties as assigned or required.