Patient Account Representative Specialist - Collections

We have an exciting opportunity to join our Revenue Cycle team as a Patient Account Representative Specialist – Collections!

Job Summary

The Patient Account Representative Specialist – Collections prioritizes and completes follow up and collection of payment for Non-Government claims in accordance with departmental policies and procedures with little to no supervision.  Responsible for successful claim payment within established accounts receivable key performance indicators.  Manages and reconciles accounts, update and document financial data, utilize excellent customer service skills to contact patients and insurance carriers to ensure accurate reimbursement in accordance with current payor contracts.  Utilizes current technology, which may include web-based products such as EPIC, SSI, Nthrive, RAC tracker, E.H.R., RTE, and payer portals.  Excellent computer skills with ability to train in Microsoft Word, Excel, and Outlook.  Experience in general accounting/bookkeeping skills, including posting of charges, payments, contractual allowances and refunds with the ability to train.  Responsible for training CBO employees on all company software systems and Non-Government follow up procedures and processes.  Adheres to policies, procedures and regulations to ensure compliance and patient safety.

Example of Responsibilities

• Responsible for identifying denials and resolve accounts receivable.  Maintains high level of productivity while managing tasks to ensure timeliness and effective follow-up and appeals.
• Maintain payer portal access
• Responsible for training staff on company systems and follow-up policy and procedures.
• Ability to root cause payment delays and/or claim payment issues.
• Researches and reports trends to identity A/R aging issues to management.
• Works with other departments to resolve A/R and payer issues.  Identifies the areas responsible for resolution of issues and identifies opportunities for clean claims to generate timely payment
• Seeks out government regulations or modifications to their payment requirements to ensure claims are billed and paid according to current requirements.
• Participates in A/R clean-up projects or other projects identified by direct supervisor or CBO management.
• Takes ownership of assignments; other duties as assigned or requested.  Seeks out other duties or recognizes need for additional assignments.
• Communicates and listens effectively both written and verbal.  Maintains internal and external customer’s relations; to ensure effective communication with Shared Coding, Clinical depts. Or Charge Master.
• Cooperates and interacts with supervisors, peers, other departments, and all customer groups demonstrating our commitment to “service”.

Education and Experience

• High School Diploma or GED equivalent.
• Associate Degree in Business or related field of study preferred.
• Three (3) years of job-related experience preferably in a Healthcare business environment.

Knowledge/Skills/Abilities

• Knowledge of medical terminology and billing/collections practices.
• Knowledge of payer edits, rejections, rules and how to appropriately respond to each.
• Accuracy in identifying the cause of rejections/denials and selecting the most appropriate method for resolution.
• Demonstrates proficiency with timely and successful appeals to insurance companies.
• Ability to demonstrate initiative and time management skills.
• Excellent analytical skills and problem-solving skills.
• Multi-task in a fast-paced environment and handle overlapping commitments and deadlines.

Depending on a candidate’s qualifications, this role may be filled at a different level.