Patient Accounts Representative organizes inpatient and outpatient claims for electronic or hard copy mail and forwards to appropriate third party payers. Reviews claims to make sure that payer specific billing requirements are met, follows-up on billing, determines and applies appropriate adjustments, answers inquiries, and updates accounts as necessary. Being a Patient Accounts Representative requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Patient Accounts Representative works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Patient Accounts Representative typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Job Summary
Answers all calls from patients and outside sources for the Central Business Office. Provides efficient, courteous service to callers.
Essential Functions
• Accepts all incoming calls and other inquiries for Central Business Office. Handles concerns, problems, answers questions, and researches issues.
• Refers issues that are beyond the scope of the department to the department best suited to handle the problem/questions via appropriate referral form.
• Meets and maintains productivity measures and quality assurance goals as established by the department.
• Documents all actions taken on each account.
• Updates and/or makes appropriate changes to insurance screens, demographic information, statement control screens, etc.
• Initiates monthly payment contract on accounts up to $1,000 for patients who meet guidelines.
• Maintains communication with collection agencies, administrative support, and cash management regarding activity on patients’ accounts as needed.
• Processes and returns patient voicemails within 24 hours of receipt.
• Resubmits accounts or combines accounts when appropriate.
• Performs all clerical functions required to handle a request to completion. Interacts with other departments, physicians’ offices, insurance companies, and attorneys’ offices to resolve issues.
• Informs supervisor of problems and recommends solutions. Makes supervisor aware of errors within/outside of Central Business Office to alert management of inter-departmental or departmental needs to change/revise.
Education, Training, and Experience
High school education required, college preferred. Previous customer service experience required. Previous experience related to billing and collection of third party payors and/or state agencies preferred.
Other Job Requirements, Licenses, Certifications Must have minimum typing speed of 45 WPM. Ability to communicate effectively withal socio-economic levels, both verbally and in writin
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