Representative, Patient Account
Pediatric Associates, Florida, NY, United States
Schedule - Shift - Hours Full Time - Days
PRIMARY FUNCTION: Patient Account Representative is responsible for managing and monitoring all tasks and communication related to the intake of information from guarantors and/or delinquent accounts to solicit payment. Other duties include: keeping records of collections and status of accounts, and taking incoming and make outbound calls to assist with patient account balances.
REPORTS TO: Patient Accounts Supervisor
SUPERVISORY RESPONSIBILTIES: None
FLSA STATUS: Non-Exempt
EXEMPTION CLASSIFICATION: None
NAICS WORKERS COMP: Administrative Support Workers
EEO: Administrative Support Workers
PAY GRADE: Grade 4 Hourly
ESSENTIAL FUNCTIONS OF THE JOB:
Monitor queue to ensure calls are being handled professionally and appropriately.
Perform analysis, research, and making decisions to appropriately handle phone inquiries.
Review accounts and responsible for completing adjustments to ensure correct reimbursement as instructed by Manager.
Identify delinquent accounts, aging period, payment sources, and correct any claim processing (data entry, verification, coding and/or posting) errors identified.
Manage requests for medical records, correspondence, and/or Explanation of Benefits (EOB). Research proper processing and/or payment of accounts from patients with or without insurance.
Responsible for collection efforts and for taking the appropriate steps to have claims processed for payment (i.e. re-submitting claims or filing claims appeal for payment or additional payment).
Keep Manager abreast of any changes, and document any problems related to work methodology procedural and recommend actions.
Identify and resolve patient billing disputes by evaluating patients’ financial status, establishing budget payment plans, collecting payments, and refunding patient credits.
Demonstrate good judgement and read and abide by the company’s code of conduct, ethics, employee handbook, policies and procedures and other corporate mandates.
Accountable for limiting the use and disclosure of Protected Health Information (PHI) for patients and employees information to the Minimum Necessary in order to perform job.
Other various duties as assigned, including cross training in other functional areas.
PERFORMANCE REQUIREMENTS: Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI in accordance with organizational policy, Federal, State, and local regulations.
TYPICAL WORKING CONDITIONS:
Operating Computer
Manual Dexterity
Lift/Carry 10 lbs. or less
Vision
Sense of Sound
Sense of Touch
EDUCATION: High School Diploma or equivalent required.
LICENSURE/CERTIFICATION: None
EXPERIENCE: Minimum 1 year of customer service experience in a healthcare setting required.
KNOWLEDGE, SKILLS & ABILITIES:
Knowledge of billing and collection policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.) Skill in defining problems, interpreting billing information.
Ability to multi-task in a face paced environment while meeting established production and quality goals/metrics.
Strong organizational skills, with ability to effectively prioritize work and daily basis and follow up on open items in a timely manner.
Must have strong verbal, written, and interpersonal communication skills
Demonstrates ability to work well in a team environment.
General PC knowledge including Microsoft Office, Internet and Email.
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PRIMARY FUNCTION: Patient Account Representative is responsible for managing and monitoring all tasks and communication related to the intake of information from guarantors and/or delinquent accounts to solicit payment. Other duties include: keeping records of collections and status of accounts, and taking incoming and make outbound calls to assist with patient account balances.
REPORTS TO: Patient Accounts Supervisor
SUPERVISORY RESPONSIBILTIES: None
FLSA STATUS: Non-Exempt
EXEMPTION CLASSIFICATION: None
NAICS WORKERS COMP: Administrative Support Workers
EEO: Administrative Support Workers
PAY GRADE: Grade 4 Hourly
ESSENTIAL FUNCTIONS OF THE JOB:
Monitor queue to ensure calls are being handled professionally and appropriately.
Perform analysis, research, and making decisions to appropriately handle phone inquiries.
Review accounts and responsible for completing adjustments to ensure correct reimbursement as instructed by Manager.
Identify delinquent accounts, aging period, payment sources, and correct any claim processing (data entry, verification, coding and/or posting) errors identified.
Manage requests for medical records, correspondence, and/or Explanation of Benefits (EOB). Research proper processing and/or payment of accounts from patients with or without insurance.
Responsible for collection efforts and for taking the appropriate steps to have claims processed for payment (i.e. re-submitting claims or filing claims appeal for payment or additional payment).
Keep Manager abreast of any changes, and document any problems related to work methodology procedural and recommend actions.
Identify and resolve patient billing disputes by evaluating patients’ financial status, establishing budget payment plans, collecting payments, and refunding patient credits.
Demonstrate good judgement and read and abide by the company’s code of conduct, ethics, employee handbook, policies and procedures and other corporate mandates.
Accountable for limiting the use and disclosure of Protected Health Information (PHI) for patients and employees information to the Minimum Necessary in order to perform job.
Other various duties as assigned, including cross training in other functional areas.
PERFORMANCE REQUIREMENTS: Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI in accordance with organizational policy, Federal, State, and local regulations.
TYPICAL WORKING CONDITIONS:
Operating Computer
Manual Dexterity
Lift/Carry 10 lbs. or less
Vision
Sense of Sound
Sense of Touch
EDUCATION: High School Diploma or equivalent required.
LICENSURE/CERTIFICATION: None
EXPERIENCE: Minimum 1 year of customer service experience in a healthcare setting required.
KNOWLEDGE, SKILLS & ABILITIES:
Knowledge of billing and collection policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.) Skill in defining problems, interpreting billing information.
Ability to multi-task in a face paced environment while meeting established production and quality goals/metrics.
Strong organizational skills, with ability to effectively prioritize work and daily basis and follow up on open items in a timely manner.
Must have strong verbal, written, and interpersonal communication skills
Demonstrates ability to work well in a team environment.
General PC knowledge including Microsoft Office, Internet and Email.
#J-18808-Ljbffr