Patient Account Representative Job Description
Patient Account Representative Duties & Responsibilities
To write an effective patient account representative job description, begin by listing detailed duties, responsibilities and expectations. We have included patient account representative job description templates that you can modify and use.
Sample responsibilities for this position include:
Patient Account Representative Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Patient Account Representative
List any licenses or certifications required by the position: GOLD, CPR
Education for Patient Account Representative
Typically a job would require a certain level of education.
Employers hiring for the patient account representative job most commonly would prefer for their future employee to have a relevant degree such as High School and Associate Degree in Healthcare, Business, Medical, Education, Computer, Medical Billing, Finance, Pharmacy, Associates, Communication
Skills for Patient Account Representative
Desired skills for patient account representative include:
Desired experience for patient account representative includes:
Patient Account Representative Examples
Patient Account Representative Job Description
- Identifies coding or billing problems from EOBs and works to correct the errors in a timely manner
- Updates the account database to identify actions that have been taken on the account
- Work with clinic and clinic managers to resolve outstanding insurance balances
- Generates and monitors all work lists specific to the collections role
- Ensures timely receipt of claim payments and minimization of unexpected bad debt
- Monitoring of assigned work lists and working with appropriate clinical regional
- Performs account receivable collection duties as assigned by billing supervisor
- Responsible for transferring balances to correct payer, and initiates re-bill of unpaid claims
- Contacts the patient's and/or third party payer organization(s) to secure insurance benefits and information
- Secures all self-pay deposits and payment while patients are in the facility
- Must be able to communicate effectively and professionally with strong attention to details and problem solving both verbally and written
- Ability to prioritize and multi task and to work in a fast paced environment with a positive attitude
- Knowledge of MS4, Midas, Emdeon would be preferred, but not required
- Monitors and reviews all new accounts and follow-up documents to determine the nature and extent of the information received from and the Intake Department
- Notifies the Business Office Manager of any delinquent information
- Contacts all payers to ensure clarification of insurance benefits and any monies due up front
Patient Account Representative Job Description
- Reclassifies accounts after insurance verification or rejection or verification and initiates required procedures
- Identifies problem delinquencies and recommends further action needed
- Maintains current knowledge of all insurance verification policies and procedures and related legislation
- Instructs and assists patients with federal, state, county or third-party payer eligibility forms, applications and processes from computer-generated reports/referrals
- Properly matches self-pay patients to a variety of third-party payer programs according to the guidelines of the reimbursement programs
- Provides or arranges for translation when necessary
- Updates and completes proper forms and documentation according to procedure for the coding, closing and suspending of accounts while updating account files
- Responsible for maintaining strong communication with Manager, informing the Manager of any upcoming hospital activities or any non-routine situations
- Research Credit Balances
- Primary contact for new Special Care Insurance Program markets
- Able to avoid making erroneous decisions or failure to take appropriate actions/steps may expose the Company or Hospital Client to lost revenue, and if a HIPAA violation, potential legal liabilities
- This position is responsible for making decisions on routine problems and working with their Manager with non-routine questions
- Routine contact with the Hospital Staff and Patients, Regional Director, Operations Manager, Operations team members and Third-Party Payers
- Data entry of charts, correspondence, or account notes as needed
- Knowledge of MS4, Midas, Emdeon/Change a plus but not required
- Enroll, bill and administer policies for residents
Patient Account Representative Job Description
- Under general supervision, post electronic and manual cash receipts, adjustments and denials
- Identifies problem accounts with payors
- Calls the individual insurance companies and patients whose balances are past due and conducts follow through with any research, re-filing, that needs to be done to obtain maximum payment
- The Patient Account Representative is responsible for preparing and submitting claims to appropriate payer(s) for payment in a timely and accurate manner while assuring the integrity of all claims
- Responsible for monitoring, evaluating and resolving assigned accounts receivable to meet the department's guidelines and goals
- Maintains a system to correct problems pertaining to reimbursement issues and claims status
- The Patient Account Representative primary responsibilities support the patient accounts department by communicating with insurance companies, utilization review staff, and clinical staff regarding claim and reimbursement issues
- Knowledge of governmental and third party payer billing and reimbursement methodology necessary
- Availity Denial Management per assignment
- Verifies and updates insurance information as required
- Participates in establishing priorities for specific departmental functions and activities
- Assists Manager in the development of educational/training materials related to the department’s functions
- 1 to 3 years hospital-patient accounts
- Management or specialized related experience in collections, accounting systems
- Must demonstrate good customer-service skills, strong written and verbal skills
- An ability to accurately investigate complaints, errors, and other operational problems and recommend the appropriate corrective action
Patient Account Representative Job Description
- Review and manages underpayment reports
- Appeals on denied claims as deemed necessary and appropriate
- Manages daily/weekly/monthly reports
- Knowledgeable of hospital and services offered
- Works main cash box efficiently and effectively
- Receipts and post payments accurately
- Reviews, corrects and approves all primary and secondary billing, submits hard copy or electronic claims to appropriate payors
- Responds to all requests for information and telephone inquiries from patient, insurance carrier, physician office and outside agencies in a courteous manner
- Responds to all requests for information and telephone inquiries from patient, insurance carrier, hospital business office and outside agencies in a courteous manner
- Evaluate account information received from the client to determine next step to resolve account and take the action necessary
- Ensures HIPAA compliance in all business practices
- Third-party Eligibility experience is preferred
- Two to three years related experience in healthcare strongly preferred
- Work requires knowledge of health care billing and collection processes including federal and state collection laws, collection practices and techniques at a level generally acquired through min
- Minimum of 3 years experience in a patient accounting or medical insurance environment preferred
- A minimum of one year of customer service experience and knowledge of current insurance processes and terminology is preferred but not required
Patient Account Representative Job Description
- Ensure the integrity of each claim that is billed is in accordance with payer regulations
- Document in detail all efforts in the required systems
- Verify patient information and benefits as required
- Responsible for the maintenance of practice Accounts Receivable according to guidelines
- Accounts Receivable maintenance includes but is not limited to claim filing, responding to correspondence in a timely manner, assisting patients with questions in regards to their account, and completion of collection steps
- Treating all clients with dignity and respect
- Persuade consumers to pay and/or set up payment arrangements and settlements on account balances
- Negotiate payment terms and methods
- Utilize skip tracing as needed
- Learn and adhere to HIPAA and PCI compliance requirements
- Must be able to communicate effectively and professionally with strong attention to details and problem solving both verbal and written
- Medical Billing and/or Medical Admin experience a plus!
- Ability to Read EOB's
- Must be able to communicate effectively and professionally with attention to details and problem solving both verbal and written
- Associates in Medical Office Management, Business, or Accounting preferred
- Knowledge of basic accounting principles and patient accounts