Patient Accounts Representative

Shift: 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.

William Newton Hospital’s Standards of Behavior allow a mechanism for holding each employee accountable and encourages us to "raise the bar". All employees are expected to familiarize themselves with the Standards and practice them daily.

• Integrity: We act with unwavering moral principle, transparency, and sincerity in every interaction.
• Patient‑Centered: We meet patients where they are, ensuring they are active participants in their care journey. We prioritize the patient's physical and emotional well‑being above all else.
• Accountability: We own our actions. We set clear expectations and hold all team members to the same high standards.
• Compassion: We treat every patient, family member, and colleague with kindness, empathy, and dignity.
• Excellence: We approach every task, large or small, with enthusiasm. We continually pursue mastery and best practices in our field.

• 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 submit claims to the proper agencies/insurance companies.
• Maintains a professional, working relationship with 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.
• Able to assist with the receipt process and adjust patients’ bills to reflect credits, debits and balances.
• Understands pre‑certification and referral processes as they relate to assigned insurance.
• Documents all correspondence and conversations with insurance companies, governmental agencies, third‑party payers and patients on patient account records.
• 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 audits using available information to verify accuracy in charges and coding.
• Maintains a good working relationship within the department and with other hospital departments.
• Coordinates with patients/insurance companies to resolve unpaid insurance claims.
• Interacts with patients/families professionally, providing explanations regarding statements and insurance procedures.
• Treats patients/families with respect and ensures confidentiality of protected patient information.
• Utilizes voicemail as necessary, ensuring quality customer communication service when out of the office.
• Prepares daily deposits and maintains correct balances in the cash drawer.
• Performs 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.
• Utilizes the safe for large bills and large amounts of money from the cash drawer.
• Provides petty cash to various hospital departments, collects daily revenues from these…