Patient Accounts Representative organizes inpatient and outpatient claims for electronic or hard copy mail and forwards to appropriate third party payers. Reviews claims to make sure that payer specific billing requirements are met, follows-up on billing, determines and applies appropriate adjustments, answers inquiries, and updates accounts as necessary. Being a Patient Accounts Representative requires a high school diploma or its equivalent. Typically reports to a supervisor or manager. To be a Patient Accounts Representative typically requires 1-3 years of related experience. May be entry level if some experience in the skill. Gains or has attained full proficiency in a specific area of discipline. Works under moderate supervision.
Patient Account Representative Job Description Template
Our company is looking for a Patient Account Representative to join our team.
- Strong interpersonal skills;
- Enter and maintain all demographic information on each patient;
- Educating and mentoring new personnel;
- Extensive previous medical experience obtaining prior authorization for services;
- Run financial estimates for chemotherapy and oral drugs and other testing;
- Ability to communicate well verbally and in writing;
- Maintain good working relationships with state and Federal agencies;
- Previous experience in healthcare accounts receivable billing required;
- Working knowledge of UB04 and 1500 claim forms, revenue codes and CPT/HCPC codes;
- Assist with various projects as assigned by direct supervisor;
- Makes necessary adjustments as appropriately required by plan reimbursement and company policy;
- Educates patient regarding financial assistance programs when appropriate;
- Makes all necessary corrections to claims that do not pass the billing edits and payer requirements;
- Answers phone inquiries regarding bills, charges, and account status;
- Four years of general collection or billing experience. OR.
- High school diploma or GED, Associates degree preferred;
- Problem identification and problem solving skills are required;
- Excellent verbal, written, and interpersonal communication skills;
- Excellent organization skills and the ability to comprehend and follow written and verbal instructions;
- Minimum of 2-3 years experience in medical billing, claims follow-up and customer service;
- Two years experience in healthcare billing;
- Demonstrates excellent customer service;
- Ability to manage and prioritize multiple tasks in fast paced environment;
- Ability to maintain composure and restore calm in stressful situations;
- Uses good judgment and diplomacy when dealing with others;
- Strong problem solving, problem prevention, and decision-making skills;
- Desire and ability to work in a team environment;
- Ability to convey empathy;
- Computer proficient with ability to learn multiple software applications;
- Ability to work with minimal supervision.