What are the responsibilities and job description for the Patient Account Representative position at Med-Metrix LLC?

Job Purpose

The Patient Account Representative is responsible for collections, account follow up, billing allowance posting for the accounts assigned to them.

Duties and Responsibilities

Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
Review and updates all patient and financial information accurately as given
Verify that information is accurate as to individual or insurance company responsible for payment of bill
Monitor all billings for accuracy, updating any that contain known errors
Monitor Medicaid / healthy options coupons to assure services are billed within expected timeframes
Bill all hospital services to primary insurer or patient correctly and within expected timeframe
Follow up with insurance companies on all assigned accounts within expected timeframe
Explain hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contracts
Identify and report underpayments and denial trends
Analyze, identify and resolve issues causing payer payment delays; Initiate appeals when necessary
Manipulate excel spreadsheets and communicate results
Meet and maintain daily productivity and quality standards established in departmental policies
Act professionally, cooperatively and courteously with patients, insurance payors, co-workers, management and clients
Perform special projects and other duties as needed by the management team
Maintain confidentiality at all times
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Qualifications

High School Diploma or equivalent required

Medical Billing and Coding certification preferred, but not required

Experience in Hospital / Facility billing required

2-3 years’ experience in insurance collections, including submitting and following up on claims

Basic knowledge of healthcare claims processing including : ICD-9 / 10, CPT and HCPC codes, as well as UB-04

Ability to use various workflow system and client host system such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accounts

Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies

Understanding of government, Medicare and Medicaid claims

Proficiency with Microsoft Office including Excel and Word

Ability to work well individually and in a team environment

Strong organizational, communication and written skills

Basic math and typing skills

Working Conditions

Physical Demands : While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.

Mental Demands : The employee must be able to follow directions, collaborate with others, and handle stress.

Work Environment : The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

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