Patient Accounts Representative Job Description
Patient Accounts Representative Duties & Responsibilities
To write an effective patient accounts representative job description, begin by listing detailed duties, responsibilities and expectations. We have included patient accounts representative job description templates that you can modify and use.
Sample responsibilities for this position include:
Patient Accounts Representative Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Patient Accounts Representative
List any licenses or certifications required by the position: AAHAM
Education for Patient Accounts Representative
Typically a job would require a certain level of education.
Employers hiring for the patient accounts representative job most commonly would prefer for their future employee to have a relevant degree such as Associate and High School Degree in Healthcare, Associates, Business, Medical Billing, Medical, Health Care, Secondary Education, Education, Accounting, High School Education
Skills for Patient Accounts Representative
Desired skills for patient accounts representative include:
Desired experience for patient accounts representative includes:
Patient Accounts Representative Examples
Patient Accounts Representative Job Description
- Responsible for contacting insurance companies concerning unpaid medical claims via telephone and website
- Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients
- Contacts insurance companies concerning unpaid accounts receivables
- Investigates and appeals unpaid or partially paid accounts
- Identifies patients accurately and assigns the patient a unique identification number
- Secures patient accounts in order to maximize reimbursements in a customer service oriented fashion
- Maximizes the efficiency and accuracy of the collection process by up- front collection and maintaining bill hold reports
- Provides documentation in the patient’s charts of general consent, information release, advanced care directives, and other requirements
- Resolves any unusual denials, low payments, or requests for information, including appeals
- Drafts letters to the insurance company’s Medical Review Board to expedite payment
- Evaluates if payments were made according to contract
- Files insurance claims and requests statements
- May provide guidance and technical work direction to less experienced Patient Account Representatives
- Follows up on outstanding accounts and makes proper notations in IDX system
- Contacts insurance companies concerning unpaid medical claims via telephone and website
- Resolves all denials, low payments, or requests for information, including appeals
Patient Accounts Representative Job Description
- Sorting, filing and scanning documents
- Processing of EOB requests
- Reviewing medical record requests
- Contacts third party payers and patients to determine the reason for non-payments or delays in payments of medical claims
- Corrects claims and re-files
- Researches and appeals insurance denials
- Confirm patient insurance eligibility and benefits
- Resolve outstanding receivables
- Process billing and payments to include Medicaid and Charity Care applications
- Review correspondence for priority or urgent mail, and process accordingly
- Two or more years of experience working specifically in the healthcare field in patient accounts, insurance verifications, medical collections, medical billing, medical office, hospital, clinic, surgery center, insurance industry, call center or similar role
- Answers patient phone calls, helps resolve patients questions
- Work with patient to establish payment arrangements or provide assistance with completing free care application
- Identifies and corrects any accounts within the scope of his/her abilities
- Recognizes when issues are outside his/her scope of transfers calls appropriately and efficiently
- Provides information to patients as appropriate, customer service being most important
Patient Accounts Representative Job Description
- Process correspondence while adhering to the correspondence matrix
- Ensure the correspondence is coded with the appropriate note code
- Provide a detailed note pertaining to the type of correspondence received and the action taken
- Identifies and refers more complex correspondence to the appropriate Rep for further processing
- Update accounts with any insurance information received
- Follows hospital policy and departmental procedure by securing specific payment agreement for account balances upon receipt of all third party payments
- Obtains completed credit application, verification of income and expenses for extended credit terms
- Receives, reviews and processes incoming mail on a daily basis in accordance to departmental procedures
- Upon personal patient contact or receipt of patient/guarantor credit application
- Initiates and answers telephone calls related to patient accounts and provides accurate information and explanation of the Medical Center’s credit policy and financial requirement
- Demonstrate strong verbal communication skills
- Works with all providers via-email and phone calls providing them with demographic information
- Works with Supervisor to transfer Allscripts AR to bad debt Collection Agency as needed
- The employee must have have a clear understanding of the entire appeals process from start to finish and also be able to work effectively with the OB/GYN Billing Operations Supervisor and the OB/GYN Coding representative document in EPIC all activity on the patient invoice
- Must have min of 2 years experience in medical office billing
- Must have experience working with appeals, denials, and follow-up
Patient Accounts Representative Job Description
- Enters into the computer all pertinent data and financial transactions to maintain an up to date record of the patient’s account
- Adds, updates and revises patient demographic and financial information maintaining current and accurate account information
- Reviews and processes insurance explanation of benefits statements for accuracy
- Turns to supervisor for unusual circumstances that may include recoups, adjustments, fee schedules, rejections
- Responsible for researching, identifying errors, and correcting claims denied by insurance companies
- Must be able to asses claim to determine when appropriate to make charge adjustments, void a charge, or escalate to the team lead and/or another medical billing team
- Responsible for following up with insurance companies for no response claims
- Responsible for working with patient calls escalated from the Customer Service team regarding involving billing code issues
- Research refund request from payor organizations
- Responsible for preliminary audit of billing code errors before claim submitted to the Coding team
- A Minimum of 1 year experience in a healthcare preferred
- Ability to answer high call volumes
- Ability to manage and resolve customer inquiries
- Ability to resolve problems by clarifying desired information, researching, locating, and providing correct information
- Must be able to adapt to a quickly changing work environment
- Ability to display a positive team player attitude
Patient Accounts Representative Job Description
- Responsible for routing complex claim denial to team lead and/or the appropriate medical billing team
- Responsible for identifying issues which can be resolved by programing software to prevent denials
- Responsible for becoming a subject matter expert on the payor policies
- Responsible for communicating and resolving problems with the provider representatives
- Responsible for simple level coding, including diagnosis review, modifier applications, some CPT cod changes following process documents and payor policies
- Be responsible for answering inbound patient calls in a call center environment
- Answer patient emails in Electronic Medical Record system
- Making outbound collection calls to patients to obtain information needed to collect payment
- Straightforward coding
- Provide price estimates for patients
- Accountable for meeting productivity standards, call quality, attendance, and adherence to work schedule results
- Prior experience in a clinical medical office preferred
- Experience with ClinStar, required
- Skills in establishing and maintaining effective working relationships with colleagues
- Requires a bachelor's degree or equivalent in education and experience
- Experience as an edit and/or claims specialist, or equivalent role providing data analysis and decision support, preferred