Patient Accounts Representative

Description Shift: 7:30a-4p Job Summary: Responsible for the insurance billing process between the hospital and insurance companies, federal agencies and third party payers. Audits patient accounts to ensure procedure, charges and coding accuracy. Collects payments from commercial insurance companies, state and federal agencies. Participates in performance improvement and continuous quality improvement (QI) activities.

Job Duties and Responsibilities: Coordinates the payment process and collects payments from insurance companies, federal and/or state agencies and/or third party payers by utilizing billing system to complete appropriate forms and submission of claims to proper agencies/insurance companies. Maintains a professional, working relationship with the insurance companies, government agencies and/or third party payers. Works independently to resolve account problems and timely follow-up. Resolves overpayments and communicates with Business Office Director on refunds. Able to assist with receipt process and adjusts patients’ bills to reflect credits, debits and balances.

Understands pre-certification and referral process as it relates to assigned insurance. Documents all correspondence and conversations with insurance companies, governmental agencies, third party payers and patients on patient’s accounts. Stays informed of changes in the insurance industry. Consults with other hospital departments to obtain, verify billing information. Always accepts other assignments as needed. Demonstrates the ability to be flexible, organized and function well in stressful situations. Communicates clearly and accurately with the Business office Director and other staff members.

Performs limited account audit using information available to verify accuracy in charges and coding. Maintains a good working relationship within the department and with other departments of the hospital. Coordinates patients/insurance companies to resolve unpaid insurance claims. Interacts with patients/families in a professional manner. Provides explanations regarding statements and insurance procedure. Treats patients/families with respect; ensures confidentiality of protected patient information. Utilizes voice mail as necessary ensuring quality customer communication service when out of the office.

Responsible for preparation of daily deposit and maintaining correct balance in cash drawer. Responsible for payment transactions, including downloading and balancing electronic remittance advices and providing customer receipts. Prepares and posts adjustments, contractuals and rejections. Responsible for entering all transactions into the computer system accurately and in a timely manner. Responsible for utilizing the safe for large bills, and large amounts of money from the cash drawer. Provides petty cash to various departments of the hospital, and collects daily revenues from these departments; provides receipts of all transactions. Responsible for providing change to…

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