Patient Account Representative

2 weeks ago


Frisco, Texas, United States Hospital RCM Services Full time
Job Summary

The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. This role requires a solid understanding of the Revenue Cycle as it relates to the entire life of a patient account from creation to payment.

Key Responsibilities
  • Researches each account using company patient accounting applications and internet resources that are made available.
  • Conducts appropriate account activity on uncollected account balances with contacting third party payors and/or patients via phone, e-mail, or online.
  • Problem solves issues and creates resolution that will bring in revenue eliminating re-work.
  • Updates plan IDs, adjusts patient or payor demographic/insurance information, notates account in detail, identifies payor issues and trends and solves re-coup issues.
  • Takes appropriate action to bring about account resolution timely or opens a dispute record to have the account further researched and substantiated for continued collection.
  • Maintains desk inventory to remain current without backlog while achieving productivity and quality standards.
Requirements
  • Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, insurance appeals, collections) procedures and policies.
  • Intermediate skill in Microsoft Office (Word, Excel).
  • Ability to learn hospital systems – ACE, VI Web, IMaCS, OnDemand quickly and fluently.
  • Ability to communicate in a clear and professional manner.
  • Strong interpersonal skills.
  • Above average analytical and critical thinking skills.
  • Ability to make sound decisions.
  • Has a full understanding of the Commercial, Managed Care, Medicare and Medicaid collections, Intermediate knowledge of Managed Care contracts, Contract Language and Federal and State requirements for government payors.
  • Familiar with terms such as HMO, PPO, IPA and Capitation and how these payors process claims.
  • Intermediate understanding of EOB.
  • Intermediate understanding of Hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms.
  • Ability to problem solve, prioritize duties and follow-through completely with assigned tasks.
Education/Experience
  • High School diploma or equivalent. Some college coursework in business administration or accounting preferred.
  • 1-4 years medical claims and/or hospital collections experience.
  • Minimum typing requirement of 45 wpm.


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