Patient Accounts Representative

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7:30a-4:30p Monday-Thursday, 7:30a-1p Friday

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.

• Coordinates the payment process and collects payments from insurance companies, federal and/or state agencies and/or third party payers by utilizing the billing system to complete appropriate forms and submissions 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 follow up in a timely manner.
• Resolves over payments and communicates with the Business Office Director on refunds.
• Assists 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 accounts.
• Stays informed of changes in the insurance industry.
• Consults with other hospital departments to obtain and verify billing information.
• 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 audits using available information to verify accuracy in charges and coding.
• Maintains a good working relationship within the department and with other departments of the hospital.
• Coordinates with patients/insurance companies to resolve unpaid insurance claims.
• Interacts with patients/families in a professional manner, providing explanations regarding statements and insurance procedures.
• Treats patients/families with respect; ensures confidentiality of protected patient information.
• Uses voicemail as necessary, ensuring quality customer communication service when out of the office.
• Responsible for preparation of daily deposits 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.
• Enters all transactions into the computer system accurately and in a timely manner.
• Uses a safe for large bills and large amounts of money from the cash drawer.
• Provides petty cash to various hospital departments and collects daily revenues from these departments; provides receipts for all transactions.
• Provides change to patients, visitors and employees.
• Receipts payments received in the Admitting Department and/or directly from the patient/family.
• Assists customers who present at the business office counter.
• Ensures security measures, placing cash drawer in safe upon closing.
• Manages and operates all equipment safely and correctly.
• Enters accurate documentation on patient account when applicable.

• Adheres to dress code; appearance is neat and clean.
• Completes annual educational requirements.
• Reports to work on time and as scheduled; completes work within the designated time frame.
• Wears identification while on duty, uses the computerized time system correctly.
• Completes hospital in‑services as required.
• Utilizes internet-based insurance resources for education, eligibility, follow‑up and billing as applicable.
• Maintains and ensures patient confidentiality at all times.
• Performs department in‑services.
• Works to maintain a good rapport and a cooperative working relationship with physicians, departments and staff.
• Represents the organization in a positive and professional manner.
• Attends committee, CQI and management meetings, as appropriate.
• Ensures…