Patient Account Rep
Rancho Mirage, California, US - 92270 Rancho Mirage, CA 92270
Job Title: Patient Account Rep
Location: Rancho Mirage, California, US - 92270
Job Type: Contract
Duration: Short Term
- Works under the direction of the Billing Manager.
- Performs follow-up and collection of unpaid insurance claims including contracts and commercial carriers as well as self-pay accounts.
- Responsible for routine and timely follow-up until the insurance carrier correctly reimburses claims. Processes claim adjustments and refunds when appropriate and reacts to incoming mail and telephone calls regarding the assigned claims and patient bills.
- Responsible for updating, noting and maintaining the integrity of the account files.
Specific Skills, Knowledge, Abilities Required:
- Knowledge of computer based claims management
- Strong windows knowledge, keyboarding skills, knowledge of database system and experience with internet applications
- Able to operate basic office equipment i.e. copiers, fax machines and calculators
- Must have an understanding of medical terminology
- Requires strong customer service and problem solving skills
- Requires the ability to handle multiple projects/tasks at the same time
- Able to prioritize workload and possess good time management skills
- Ability interpret contracts, billing regulations and complex claim requirements
- Ability to lead and create motivated workers
- Completes annual health, safety, compliance reviews and any department/hospital specific requirements within the expected timeframe.
- Corrects and/or reports any unsafe conditions to extension 4759 or email@example.com.
- Adheres to hospital and department safety and compliance policies and procedures.
- Understands the importance of immediately reporting on-the-job injuries online and to your supervisor.
- Wears identification badge at all times ensuring it can be read.
- Accepts responsibility for own work; develops trust and credibility with peers, supervisors & customers.
- Maintains sound judgment and reasoning; analyzes problems or procedures & selects correct course of action.
- Treats co-workers as teammates; accepts/supports team decisions and the roles of others.
- Monitors own work to ensure quality; participates in continuous quality improvement.
- Engages in opportunities to learn and grow by participating in training and educational programs.
- Acknowledges each person in a friendly contact & offers assistance as needed.
- Provides an enhanced level of service by taking immediate action in addressing customer requests, needs, and concerns.
- Uses pleasant/appropriate tone and positive verbal/nonverbal/written communication at all times.
- Answers telephone by identifying department and name; and asks “How may I help you?”
- Treats everyone with courtesy and respect, not making excuses nor blaming other employees or departments; works together to improve customer service.
- Maintains a professional image and a clean, orderly environment that portrays an overall image of excellence.
- Promotes a culture of healing by creating a quiet, calm, pleasant and cheerful environment.
- Demonstrates compassion when dealing with difficult situations & takes initiative to resolve.
- Creates a positive environment by not engaging in inappropriate communication.
- Demonstrates a positive, can-do attitude and embraces the culture of performance excellence.
- Adheres to all hospital, division and departmental policies and procedures.
- Balances individual/team responsibilities to produce more efficiently. Helps others during slow periods.
- Adheres to all rules & standards around productivity, timeliness, overtime, & meal/rest periods.
- Provides helpful, courteous, timely, and accurate responses to all individuals & pays attention to detail.
- Makes a concerted effort to conserve hospital resources, i.e. electricity, supplies, water.
- Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
- Manages new accounts, on a daily basis, by contacting payer to determine if the account has been received and/or if additional information is required. Assigns follow-up dates in accordance with follow-up guidelines.
- Account resolution of all self-pay accounts including self-pay after insurance.
- Manages new credit balance accounts every day and prepares adjustments or refunds to zero the account balance
- Works all accounts listed in the Follow-Up cue, on a daily basis to promote collection of accounts. This will include telephoning the payer or identifying the claim on the payers’ Internet location.
- Manages entire account inventory on a timely basis to promote payment and resolution of all accounts prior to ninety days from date of billing.
- Answers incoming telephone call from patients who call with questions/information regarding their bills
- Responds appropriately to incoming mail from patients or payers regarding their assigned accounts
- Processes incoming hard copy explanation of benefits and reacts appropriately to resolve the accounts.
- Records accurate and definitive notes in the electronic account file that depict the current status of account, issues with account and anticipated date of resolution.
- Escalates account management to manager when extraordinary issues arise.
- Obtains and records “Promise to Pay” amounts on a daily basis that are consistent with the cash collection goals of the department
- Assigns a status codes to each worked account to enable account tracking, statistical data gathering and audit activities.
- Identifies work unit issues and participates in solutions and problem solving by working with manager and staff members.
- Attends staff meeting, in-house training and attends classes pertaining to Federal and State billing regulations as well as Compliance Issues and Guidelines when requested
- Performs other job related tasks as assigned by Supervisor
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