Patient Account Representative II - Collections (Remote)

We have an exciting opportunity to join our Revenue Cycle team as Patient Account Representative II - Collections.

The Patient Account Representative II – Collections prioritizes and completes A/R collections in accordance with departmental policies and procedures within established deadlines for hospital and/or physician claims. Update and document financial data, utilizing excellent customer service skills to contact patients and insurance carriers to ensure accurate reimbursement. Must have computer skills with basic knowledge of Microsoft Word, Microsoft Excel and Microsoft outlook. Basic knowledge of general accounting/bookkeeping skills. Adheres to policies, procedures and regulations to ensure compliance and patient safety.

Examples of Responsibilities:

·       Responsible for working A/R collection opportunities on unpaid claims through provided work queues.

·       Maintains required levels of productivity and quality while managing tasks to ensure timeliness of analytic report resolution.

·       Uses identified and known resources to accomplish collection related tasks, including but not limited to payor websites, provider service lines, analytics and correspondence.

·       Based on aging thresholds, obtains status of claim payment, payment amount and date of payment from insurance company (government or managed). 

·       Works to identify payment resolution when an insurance company does not provide payment information for a claim (this may include steps such as working with billing, coding, cash or other areas to resolve).

·       Based on department processes, responsible for escalating problem claims to management with clear explanation of the problem, if multiple claims are impacted and possible resolution.

·       Responsible for voiding invalid claims through payer portal, uploading to a payor portal or mailing requested documentation (such as medical records or itemized bills), researching payor provider manual or other steps to move claim forward to payment status.

·       Based on department processes, responsible for escalating problem claims to management with clear explanation of the problem, if multiple claims are impacted and possible resolution.

·       Responsible for filing an appeal according to department protocols and guidelines.

·       Responsible for filing reconsideration requests for insurance contractual underpayments.

·       Responsible for reviewing and submitting notification of overpayments (patient or insurance) according to department protocols and guidelines.

·       Participates in A/R clean-up projects or other projects identified.

·       Takes ownership of assignments; other duties as assigned or requested.

·       Communicates and listens effectively with internal and external customers; effectively understands instructions and shares knowledge.

·       Cooperates and interacts with supervisors, peers, other departments, and all customer groups demonstrating our commitment to “service”.

·       Provides training to new or existing staff as directed by leadership, when necessary.

·       Works to identify root cause on claim denials, underpayments and overpayments to help improve efficiencies and expedite cash on future claims.

·       Demonstrates leadership qualities and initiative amongst peers and coworkers.

·       Other duties as assigned.