Patient Accounts Rep Job Description
Patient Accounts Rep Duties & Responsibilities
To write an effective patient accounts rep job description, begin by listing detailed duties, responsibilities and expectations. We have included patient accounts rep job description templates that you can modify and use.
Sample responsibilities for this position include:
Patient Accounts Rep Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Patient Accounts Rep
List any licenses or certifications required by the position: CMS
Education for Patient Accounts Rep
Typically a job would require a certain level of education.
Employers hiring for the patient accounts rep job most commonly would prefer for their future employee to have a relevant degree such as Associate and High School Degree in Associates, Accounting, Supervision, Medical Terminology, Bookkeeping, Legal, Business, Healthcare, Medical Billing, Medical
Skills for Patient Accounts Rep
Desired skills for patient accounts rep include:
Desired experience for patient accounts rep includes:
Patient Accounts Rep Examples
Patient Accounts Rep Job Description
- Run audit journals and balance each batch to deposit or check total, electronic manual postings and deposits
- Copy EOB’s for refunds and/or priority alerts to follow-up as needed (massive denials, payer paid or approved 100% of charge amount)
- This customer service position is for answering phones from patients, insurance companies
- Sends itemized patient account statements per attorney request or in response to subpoena in a professional and diligent manner
- Advises patient or guarantor of third party payer benefits and estimated private payer amount and collects partial payments prior to admission in a manner that promotes the provision of high quality health care services by the department
- Reviews patient papers and documentation for reported information accuracy, and researches errors on patient accounts, billing and insurance problems, and lost payments in order to ensure accurate record maintenance and prudent departmental operation
- Makes written and verbal inquiries to third party payers, reconciles patient accounts, and makes payment arrangements in an effort to ensure that patients are free from financial burden and that patient interests are appropriately represented
- Coordinates and originates payroll deduction actions for hospital employees in accordance with established policies and procedures, and oversees collection letter mail-outs for delinquent unpaid patient accounts in a prudent and efficient manner
- Works with external agencies and companies to provide patients with prompt reimbursement for hospital services
- Identifies areas where consistent payment delays, claim denials, or reduced payment are occurring and works with physicians and administrators to resolve associated deficiencies
- Three (3) or more years of experience with claim edits/denials, working with EOBs, knowledge of CPT4/ICD9 coding
- Strong computer skills, writing skills, analytical skills
- Ability to prioritize and organization tasks assigned
- Reviews explanation of benefit and correspondence received from third party payers
- CPC Coding Certification required
- Minimum two (2) years businesses experience, preferably in the health care field, required
Patient Accounts Rep Job Description
- Requires independent judgment and frequent communication outside of the work group is required to resolve coding and coverage issues, reach agreements and clarify issues/processes
- Reviews reports of patient accounts with duplicate charges
- Requires competence in the usage of multiple electronic medical record systems and other electronic resources
- Informs manager of recurring coding errors and reimbursement denials that may indicate billing/coding compliance issues
- Researches and performs audits on patient accounts to determine where balances are due, from third party payers or patient responsibility
- Works with third party payers regarding payment denials to identify what the issue is
- Thorough understanding of how to identify if charges on a patient's account are correct
- Ability to identify if a payment was posted erroneously, also familiar with managed care contract reimbursement rates
- Responds to patient inquiries via mail, phone and/or email within 48 hours
- Understands Medicare reimbursement of DRGs, APCs or physician fee schedules
- Knowledge of Shared Medical Systems (SMS), preferred
- Strong verbal and written communication skills, highly motivated, detail-oriented and
- Is fluent and knowledgeable in both the hospital and clinic patient accounting systems
- Researches both debit and credit balances to determine the third party payer or patient's liability
- Documents all patient encounters on appropriate patient account/claim utilizing notes in both PLUS and Star
- Minimum of 2 years’ medical collection experience
Patient Accounts Rep Job Description
- Maintains data in billing management system, updating current and adding new demographic information, and ensures that documentation entered is accurate and complete
- Maintains open communication with management regarding billing and coding issues including documentation, denials/appeals
- Printing of all lockboxes for imaging and batch tracking with deposit date, group, and batch amount
- Uploading the daily download and putting the payments into the Cash Clearing System
- Updating the Daily Deposit Spreadsheet
- Scanning checks daily into the 5th 3rd bank account and batch tracking with deposit date, group and batch amount
- Printing and batch tracking the CRNA groups
- Printing remits off of carrier websites along with zero pay remits
- Sorting the mail by carrier
- Working spreadsheets for the close of the batch period
- Two years experience working in hospital billing and collection of third party and self-pay accounts
- Experience in MS4, Midas, Emdeon and Microsoft Office products
- Proficiency with Excel and Word is required
- Minimum of 1 year medical billing in acute care or ambulatory care setting or medical billing certification from an approved program, required.Prior experience in physician office operations, preferred.Prior experience in physician revenue cycle claim creation and resolution, preferred
- Minimum of 1 year medical billing in acute care or ambulatory care setting or medical billing certification from an approved program, required
- Prior experience in physician office operations, preferred.Prior experience in physician revenue cycle claim creation and resolution, preferred
Patient Accounts Rep Job Description
- Update patient accounts using appropriate documents and information
- Verify insurance coverage with carrier
- Review run sheet, enter all patients demographic
- Identify and correct all errors prior to billing
- Complete the medical necessity form for all Medicare and if needed Medicaid patients
- On a daily basis, make address and/or insurance corrections received after the initial bill has been mailed when requested or as provided to CEMS via the mail
- Correct bills that have received a rejection and resubmit claims to proper insurance company
- Accurately process manual forms and forward to respective insurance company in a timely manner
- Assist with telephone inquiries in a courteous and professional manner
- Transfer accounts to private payment pay plan if deemed necessary
- 1 year experience or related certification program in areas such as billing, medical office, coding and accounting
- Previous banking or refund experience
- CPT/ICD9 coding experience preferred
- Must have accurate typing skills
- Must be available during normal business hours
- Analyzes and researches reasons for outstanding billed accounts receivables
Patient Accounts Rep Job Description
- Must maintain confidentiality of patient, corporate, and employee records and information
- Retrieves and opens all incoming mail and distributes correspondence to appropriate Patient Accounting staff
- Retrieves daily Electronic Remittance Advice (ERA) for eligible payers and online patient payments
- Accurately and efficiently performs cash application responsibilities
- Prepares daily bank deposit and reconciles daily cash receipts against bank deposit
- Posts all payments to the appropriate systems within one business day of receipt
- Documents denials by posting zero payments and appropriate remittance codes
- Collaborates with Patient Accounting staff to rectify cash application errors, payment transfers
- Prepares deposits and completes general ledger (GL) entries for physician practices and offsite hospital departments
- Demonstrates proficiency with contractual allowances, and calculation of any outstanding balances after payment
- Works accounts according to the priority determined by the Meditech work list or as assigned by the supervisor
- Corresponds with third party payers, according to established protocols, to obtain status and requirements for payment
- Requests information from other internal and external sources (hospital departments, physician offices, patients, ) in order to respond to requests and resolve claims favorably
- Accesses and processes correspondence on a daily basis – within three days of receipt
- Appeals all technical / administrative denials
- Analyzes credit balances