Patient Accounts Representative

Shift: 7:30a-4:30p Monday-Thursday, 7:30a-1p Friday Job Summary Responsible for the insurance billing process between the hospital and insurance companies, federal agencies and third‑party payers. Audits patient accounts to ensure procedure, charges and coding accuracy. Collects payments from commercial insurance companies, state and federal agencies. Participates in performance improvement and continuous quality improvement (QI) activities. Standards of Behavior William Newton Hospital’s Standards of Behavior allow a mechanism for holding each employee accountable and encourages us to "raise the bar". All employees are expected to familiarize themselves with the Standards and practice them daily. Integrity: We act with unwavering moral principle, transparency, and sincerity in every interaction. Patient‑Centered: We meet patients where they are, ensuring they are active participants in their care journey. We prioritize the patient's physical and emotional well‑being above all else. Accountability: We own our actions. We set clear expectations and hold all team members to the same high standards. Compassion: We treat every patient, family member, and colleague with kindness, empathy, and dignity. Excellence: We approach every task, large or small, with enthusiasm. We continually pursue mastery and best practices in our field. Job Duties and Responsibilities Coordinates the payment process and collects payments from insurance companies, federal and/or state agencies and/or third‑party payers by utilizing the billing system to complete appropriate forms and submit claims to the proper agencies/insurance companies. Maintains a professional, working relationship with insurance companies, government agencies and/or third‑party payers. Works independently to resolve account problems and follow‑up in a timely manner. Resolves overpayments and communicates with the Business Office Director on refunds. Able to assist with the receipt process and adjust patients’ bills to reflect credits, debits and balances. Understands pre‑certification and referral processes as they relate to assigned insurance. Documents all correspondence and conversations with insurance companies, governmental agencies, third‑party payers and patients on patient account records. Stays informed of changes in the insurance industry. Consults with other hospital departments to obtain, verify billing information. Always accepts other assignments as needed. Demonstrates the ability to be flexible, organized and function well in stressful situations. Communicates clearly and accurately with the Business Office Director and other staff members. Performs limited account audits using available information to verify accuracy in charges and coding. Maintains a good working relationship within the department and with other hospital departments. Coordinates with patients/insurance companies to resolve unpaid insurance claims. Interacts with patients/families professionally, providing explanations regarding statements and insurance procedures. Treats patients/families with respect and ensures confidentiality of protected patient information. Utilizes voicemail as necessary, ensuring quality customer communication service when out of the office. Prepares daily deposits and maintains correct balances in the cash drawer. Performs payment transactions, including downloading and balancing electronic remittance advices and providing customer receipts. Prepares and posts adjustments, contractuals and rejections. Enters all transactions into the computer system accurately and in a timely manner. Utilizes the safe for large bills and large amounts of money from the cash drawer. Provides petty cash to various hospital departments, collects daily revenues from these departments, and provides receipts for all transactions. Provides change to patients, visitors and employees. Receives payments in the Admitting Department and/or directly from the patient/family. Assists customers who present at the business office counter. Ensures security measures, placing the cash drawer in the safe upon closing. Manages and operates all equipment safely and correctly. Enters accurate documentation on patient accounts when applicable. Requirements Professional Requirements Adheres to dress code; appearance is neat and clean. Completes annual educational requirements. Reports to work on time and as scheduled; completes work within designated time frame. Wears identification while on duty, uses the computerized time system correctly. Completes hospital in‑services as required. Utilizes web‑based insurance resources for education, eligibility, follow‑up and billing as applicable. Maintains and ensures patient confidentiality at all times. Performs department in‑services. Works to maintain a good rapport and a cooperative working relationship with physicians, departments and staff. Represents the organization in a positive and professional manner. Attends committee, CQI and management meetings, as appropriate. Ensures compliance with policies and procedures regarding department operations, fire, safety and infection control. Complies with all organizational policies regarding ethical business practices. Communicates the mission, vision and core values of the hospital. Demonstrates knowledge of and/or location of Safety/Emergency Preparedness Manual, location of disaster packets, personal protective equipment and responsibilities during all codes. Adheres to compliance with William Newton Hospital’s policies; demonstrates familiarity with the employee handbook. Regulatory Requirements High‑school graduate or equivalent. Thorough understanding of different insurance plans, government agencies, Medicare and Medicaid as relates to assigned insurance responsibilities preferred. Previous billing experience preferred. #J-18808-Ljbffr William Newton Hospital