Patient Account Representative

ESSENTIAL FUNCTIONS

• Provides excellent customer service in alignment with our “World Class Service” expectations by promptly answering patient inquiries, going above and beyond with follow-through actions, and always maintaining a positive demeanor while interacting with customers, both internal and external.
• Assists patients and family members with billing and account questions including following up with insurance companies and internal departments as needed.
• Works to resolve complaints at first contact wherever possible. Ensures all encounters are handled in a courteous, professional, and confidential manner.
• Proactively works outstanding patient balances by contacting patients to arrange payment on outstanding accounts. Ensures patient balances are resolved promptly.
• Analyzes account for proper claims processing and payment posting through inquiries from patients or staff.
• Adheres to Business Office Patient Account Representative Occupancy rate standards for incoming patient phone calls.
• Provides patients with estimated fee quotes and can explain insurance terms and regulations to assist patients in understanding their insurance benefits.
• Verifies the accuracy and timeliness of patient demographics and billing activities and identifies problems and trends.
• Communicates with insurance and collection agencies. Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement.
• Establishes and maintains effective communication with clinics, co-workers, and other departments as required.
• Works to ensure that all assigned reports are worked accurately and promptly.
• Maintains account receivables, identifying potential problems through registration, charge corrections, duplicate accounts, and refunds.
• Provides feedback to management on issues that prevent timely reimbursement from payers due to contract, provider, and insurance company or system limitations.

EDUCATION

• High school diploma/GED or equivalent working knowledge preferred.

EXPERIENCE

• Requires a minimum of two to three years of experience in billing or collections in a physician clinic or hospital environment.

KNOWLEDGE

• Knowledge of medical billing and collection policies and procedures, ICD, and CPT coding.
• Advanced computer knowledge, including Windows-based programs.
• Knowledge of legal and regulatory government provisions.

SKILLS

• Skill in establishing and maintaining effective internal and external working relationships.
• Skilled in defusing difficult situations and able to be consistently pleasant and helpful.
• Skill in resolving billing and payment issues.

ABILITIES

• Ability to multi-task in a fast-paced environment. Must be detailed oriented with strong organizational skills.
• Ability to interact professionally with patients, providers, and the public.
• Ability to read communicate clearly and effectively in English.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching are required.
• Manual dexterity using a calculator and computer keyboard.

ORGANIZATIONAL REQUIREMENTS

• HOPCo Mission, Vision, and Values must be read and signed.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.