Patient Account Representative Non-Government

Patient Account Representative Non-Government

The Patient Account Representative Non-Government accurately analyzes and collects balances on patient accounts and helps with charges, filing, and following up with third party insurance claims in a timely manner. Working under general supervision, this role ensures thorough, concise, and up-to-date documentation is maintained in accordance with procedure, so that collection efforts, responses to inquiries, and patient account status can be researched and verified. This role works with non-government payers.

Essential Job Functions

• Acts as a liaison between the organization and multiple third-party payers.
• Initiates contact with third parties to identify and subsequently resolve obstacles affecting payment.
• Reviews third party remittance advices to ensure compliance with expected reimbursements and to initiate further action as needed to facilitate full reimbursement.
• Pursues unsettled insurance accounts in the method and manner prescribed by policy so that no more than 10-15 claims go beyond the 60-day standard per year without appropriate resolution or action taken.
• Analyzes account balances to ensure accuracy of account for appropriate adjustments according to federal/state laws and hospital preferred provider contracts and in a timely manner.
• Responds to requests to ensure reimbursement is obtained.
• Ensures thorough, concise, and up-to-date documentation is maintained in accordance with procedure, so that collection efforts, responses to inquiries, and patient account status can be researched and verified, as necessary by all reps for customer service to utilize to assure accurate response in patient inquiry resolutions.
• Performs other duties as assigned.

Education

• Required: High School Diploma or equivalent

Experience

• Required: 3 years of reimbursement experience in a hospital, clinic or medical business office