Patient Accounts Representative

Patient Accounts Representative

Salary Range $18.19 - $21.40 Hourly

Job Summary

The Patient Accounts Representative is responsible for submitting claims, analyzing payer denials and problem solving to resolve unpaid claims. Responsible for posting payments from payers accurately and timely.

Reports to: Patient Accounts Manager

Supervision Exercised: None

Education/Experience/License/Certification:

• High School Degree or equivalent
• One year medical billing experience required
• Experience with Medicaid, Medicare, HMO/PPO's, and/or other Third Party Payers
• Valid driver's license and auto insurance as required by law.

Required Travel: Occasional local travel may be required.

Knowledge/Skills/Abilities:

1. A working knowledge of CPT and ICD-10-CM coding helpful.
2. A working knowledge of insurance billing.
3. Essential to have ability to understand verbal information/instruction, to exchange verbal information with others and to present information verbally.
4. Essential to have ability to read and understand written materials, and ability to compose information/instruction in written form.
5. Essential to be able to reason mathematically, to have analytical and problem solving skills.
6. Ability to speak Spanish helpful.

Essential Duties and Responsibilities:

• Ensure the function and activities of this department to embrace the philosophy, mission, values and Communicate with Heart service model supported by the Board of Directors of Pueblo Community Health Center, Inc.
• Adhere to the guidelines and procedures of Pueblo Community Health Center, Inc.
• Responsible for submitting daily electronic claims and paper claims to clearinghouse and insurance payers.
• File all applicable insurance forms for Center's patients.
• Process appeals, refund requests and inquiries. Make any necessary adjustments to accounts in order to comply with PCHC programs and insurance carriers.
• Analyze account balances to accurately bill patients for balance due
• Assist patients with billing questions.
• Review insurance aging reports to identify unpaid claims for resolution.
• Arrange payment schedules with patients for collection of past due accounts.
• Inform Patient Account Manager of any noncompliance issues.
• Assist in training of new Patient Accounts Representatives and participate in cross-training as directed by the Patient Account Manager.
• Participate in department and General Staff Meetings.
• Work outstanding tasks for encounter resolution in practice management system.
• Make inquires via telephone or payer website on patient encounters for payment resolution.
• Perform other related duties as assigned.

The above duties are not all inclusive and are not intended to limit or define the duties that may be assigned.

Physical Demands:

• The employee frequently communicates with employees and the public and must be able to exchange accurate information while performing patient care tasks and routine office tasks.
• The employee occasionally retrieves and disseminates information using written materials and electronic devices.
• The employee frequently observes, receives and otherwise obtains information from all relevant sources and identifies information by categorizing, recognizing differences or similarities, and detecting changes in circumstances or events.
• The employee frequently utilizes dental equipment requiring manual dexterity with both hands and fingers in order to maintain dental and basic lab activities in a dental clinic.
• The employee occasionally operates computers and other office productivity equipment.
• The employee occasionally remains in a stationary position while performing patient care tasks and routine office tasks.
• The employee frequently moves about the office; and positions self while performing patient care tasks and routine office duties such as accessing files and operating equipment.
• The employee frequently moves or positions objects weighing up to 25 pounds and occasionally up to 50 pounds while performing routine office duties such as opening file drawers, moving patient files, etc.

Closing Date: Open until filled.

Pueblo Community Health Center is a tobacco-free workplace. EOE