Patient Account Representative in Plantation, Florida at Pediatric Associates

PRIMARY FUNCTION

Patient Account Representative is responsible for managing and monitoring all tasks and communication related to the intake of information from guarantors and/or delinquent accounts to solicit payment. Other duties include keeping records of collections and status of accounts and taking incoming and making outbound calls to assist with patient account balances.

ESSENTIAL DUTIES AND RESPONSIBILITIES

This list may not include all the duties that may be assigned.

1. Monitor queue to ensure calls are being handled professionally and appropriately.

1. Perform analysis, research, and making decisions to appropriately handle phone inquiries.

1. Review accounts and responsible for completing adjustments to ensure correct reimbursement as instructed by Manager.

1. Identify delinquent accounts, aging period, payment sources, and correct any claim processing (data entry, verification, coding and/or posting) errors identified.

1. Manage requests for medical records, correspondence, and/or Explanation of Benefits (EOB). Research proper processing and/or payment of accounts from patients with or without insurance.

1. Responsible for collection efforts and for taking the appropriate steps to have claims processed for payment (i.e., re-submitting claims or filing claims appeal for payment or additional payment).

1. Keeps Manager abreast of any changes, and documents any problems related to work methodology procedural and recommends actions.

1. Identify and resolve patient billing disputes by evaluating patients’ financial status, establishing budget payment plans, collecting payments, and refunding patient credits.

1. Demonstrate good judgement and read and abides by the company’s code of conduct, ethics, employee handbook, policies and procedures and other corporate mandates.

1. Accountable for limiting the use and disclosure of Protected Health Information (PHI) for patients and employee’s information to the Minimum Necessary to perform the job.

1. Other various duties as assigned, including cross training in other functional areas.

QUALIFICATIONS

EDUCATION:

• High School Diploma or equivalent required.

• Experience may commensurate education.

EXPERIENCE:

• Minimum 1 year of customer service experience in a healthcare setting required.

KNOWLEDGE, SKILLS, AND ABILITIES

• Knowledge of billing and collection policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.) Skill in defining problems, interpreting billing information.

• Ability to multi-task in a face paced environment while meeting established production and quality goals/metrics.

• Strong organizational skills, with ability to effectively prioritize work and daily basis and follow up on open items in a timely manner.

• Must have strong verbal, written, and interpersonal communication skills.

• Demonstrates ability to work well in a team environment.

• General PC knowledge including Microsoft Office, Internet, and Email.

TYPICAL WORKING CONDITIONS

• Non-patient facing

• May be either full time remote/telework or rotate working in the office and remote/telework.

• This job must be U.S. based.

• Indoor Work

• Operating Computer

• Reach Outward

• Manual Dexterity

• Lift/Carry 10 lbs. or less.

• Sitting

OTHER PHYSICAL REQUIREMENTS

• Vision

• Sense of sound

• Sense of touch

PERFORMANCE REQUIREMENTS

Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI (Protected Health Information) in accordance with organizational policy, Federal, State, and local regulations.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to be an accurate reflection of the general nature of level of the job.