Patient Account Rep

Patient Account Representative

Reports to: Director of Revenue Cycle Management

FLSA Status: Non-Exempt Personnel Supervised: None

Minimal Qualifications:

• Minimum of 1-3 years healthcare experience working in a managed care, revenue cycle or billing office setting
• Knowledge of medical terminology or concepts is a must
• Proficiency in Microsoft Office applications including Word, Power Point, Excel, and Outlook is a must.
• High school graduate or equivalent required.

Responsibilities and Performance Expectations Include, But Are Not Limited To, The Following:

• Responsible for prompt and accurate submission and follow-up of all third-party claims
• Post insurance payments, adjustments and denials
• Responsible for correctly identifying and updating various types of insurance entry information.
• Submit medical and dental claims for prompt payment
• Review, research and correct all claims on hold or denied due to insurance eligibility or billing errors
• Manage Electronic Remittances, sort mail and upload EOB's
• Sort mail, upload and review EOB's and reconcile patient accounts
• Answer questions related to patient accounts
• Work closely with center leaders, center staff and insurance companies to resolve insurance and claim holds.
• Follow up on patients with balances due to collect payment
• Ensure that accounts are transferred to the appropriate responsible party for reimbursement (insurance, secondary payer or patient)
• Maintains trending of claim denials reasons to assist with training and education to staff
• Submit additional paper work, documentation necessary to re submit claims for payment
• Notify patient of non-sufficient funds
• Assist with reports related to trends and accounts receivable for management
• Federal laws and regulations affecting coding requirements
• Electronic Health Records
• Knowledge of billing practices and billing office functions required, FQHC preferred
• Knowledge of medical records, E H R required
• Must have good math skills and effective communication skills
• Must have good problem-solving skills
• Communicating clearly and concisely, orally and in writing
• Confidentiality
• Ability to use the computer
• Ability to work independently to accomplish assigned work in a timely manner
• Ability to communicate with staff and the public, both in person and over the phone, in a tactful manner and under difficult situations
• Understanding and carrying out verbal and written directions
• Follow CFHC policies and procedures
• Works independently in the absence of supervision

Physical Requirements:

• Works under pressure and stress due to the diversity of our clinics
• Work is performed indoors in a heated, air conditioned, well lighted and clean office setting
• Requires frequent lifting up to 20 pounds, and infrequent lifting up to 50 pounds
• Requires ability to distinguish letters, numbers and symbols
• Requires normal range of vision
• Requires awareness of personal limitations and flexibility
• Some emotional stress resulting from diversity and intensity of patients and staff
• Requires prolonged standing or sitting
• Occasional travel required

American with Disabilities Act (ADA) Statement: External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.