Patient Accounts Rep

Responsibilities Position Summary

The Patient Account Representative is responsible for sub preocupación of electronic and manual billings, account statements, and for follow‑up with third‑party payers and patients for outstanding balances, including financial counseling. This position is also responsible for the preparation and maintenance of insurance and Treatment Authorization Request logs daily.

Education: High school graduate or equivalent.

Experience: A minimum of two (3) years’ experience in insurance billing and/or patient accounting is required. Experience with Medicare, Medi‑Cal, and other major payors, computers, and business software programs required.

Additional Requirements: May be required to work occasional overtime and flexible hours.

• Proven analytical and problem‑solving skills.
• Exceptional verbal and written communication skills.
• High time management and organizational skills.
• Minimum of 3 years’ experience in a patient accounting or medical insurance environment.

• Prepare all accounts for billing and ensure account billing productivity standards are met.
• Prepare and submit insurance billings to primary and secondary payers.
• Prepare and submit all Treatment Authorization Requests (TAR) for Medi‑Cal/County pay.
• Contact all payers at 30‑day intervals after billing to ensure bills have been received and are being processed.
• Contact all payers on insurance billings at least twice every 30 days for payment status.
• Answer correspondence within 72 hours of receipt.
• Maintain a current tickler and/or aging system for prompt follow‑up on billing cycles.
• Document contacts on a productivity log.
• Ensure account activity is current and accurately documented.
• Update financial class of accounts if there is secondary insurance to be billed.
• Complete a denial notification notice when payments are denied and ensure documentation on the folderаҳähler.
• Maintain an up‑to‑date Midas system when receiving denial and provide chart and denial documentation to the U/R department for review.
• Prepare billing reports as required by the department.
• Review all records and uniform billings (UBS) for third‑party payers for accuracy.
• Provide follow‑up on progress of appeals and prepare documentation as required.
• Maintain Medicare and Medicaid statistical logs and databases.
• Prepare departmental billing and statistical reports as required.
• Adhere to facility, department, corporate, personnel, and standard policies and procedures.
• Attend all mandatory facility in‑services and staff development activities as scheduled.
• Adhere to facility standards concerning conduct, dress, attendance, and punctuality.
• Support facility‑wide quality/improvement goals and objectives.
• Maintain confidentiality of facility employees and patient information.
• Discuss payment arrangements with patients for outstanding balances.
• Establish payment arrangements with the patient and document appropriately in the practice management system.

Note: The essential job functions of thisੌ position are not limited to the duties listed above.

This section describes what knowledge, skills, and ability an employee in this position should currently possess. This list may not be complete for all knowledge, skills, and abilities required for this position.

• Knowledge of all code procedures.
• Knowledge of computers and business software.
• Knowledge of insurance billing.
• Skill in telephone etiquette and paging procedures.
• Effective oral and written communication skills.
• Ability to adhere to safety policies and procedures.
• Ability to use good judgment and to maintain confidentiality of information.
• Ability to work as a team player.
• Ability to demonstrate tact, resourcefulness, patience, and dedication.
• Ability to accept direction and adhere to policies and procedures.
• • Ability to recognize the importance of adapting to the various patient age groups (adolescent, adult, and geriatric).
  • Ability to work in a fast‑paced environment.
  • Ability to react calmly and effectively in emergency situations.
  • Ability to meet corporate deadlines.

This section describes how an…