JOB TITLE: Patient Accounts Representative IV
REPORTS TO: Coding & Compliance Manager
FLSA STATUS: Non-exempt
JOB OVERVIEW: Provide patient account support at a specific site(s) including billing, collections, billing adjustments, credit and third-party payments.
ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO:
1. Interpret and communicate information regarding credit policies and procedures, billing practices, insurance submissions and out-of-pocket patient responsibility to patients, physicians and clinic staff. Inform self-pay patients of their insurance options.
2. Serve as a liaison between the clinic and the central Business Office.
3. Verify eligibility and benefits for patients; set up payment plans as necessary.
4. Ensure accurate account information in all billing areas. Obtain correct information and update system when billing information is incorrect or missing.
5. Facilitate and monitor the implementation of all clinic Business Office policies and procedures at the site.
6. Check fee tickets for correct coding and enter charges within 24 hours.
7. Resolve account discrepancies by auditing account detail.
8. Reconcile missing fee ticket report on a monthly basis. Approach physicians/providers to get fee tickets in on a daily basis.
9. Effectively process patient and clinic correspondence, including requests for refunds and collections when warranted.
10. Respond to inquiries from patients, physicians and employees to assist in the claim payment process, billing, registration or establishment of payment plans.
11. Conduct training with physicians and clinic staff regarding Business Office policies, procedures, coding, registration, and use of clinic billing system.
12. Complete all special billings including but not limited to attorney billings, SSI and DVR.
13. Must have an understanding and/or basic knowledge of all the duties of Patient Accounts I, II and III positions including the ability to perform the jobs if needed.
1. Assist other business office personnel in the performance of their duties as assigned and as workload permits.
2. Maintain confidentiality of sensitive information.
3. Work as a team member within the business office and all other departments in a collaborative, constructive manner.
4. Document work processes as required.
5. Perform other duties as assigned.
Education: High school diploma or equivalent. Associates Degree in Business preferred.
Certification/Licensure: CPC preferred.
Experience: Minimum 5 years experience in health care environment including minimum of 3 years experience in patient accounts.
1. Ability to communicate in the English language in person, by phone and in writing in a clear, concise and professional manner.
2. Ability to resolve problems with minimal assistance.
3. Must possess CPT and ICD coding skills as well as familiarity with clinical operating policies and procedures, insurance industry practices and Managed Care principles.
4. Must possess excellent analytical skills including the ability to collect data from a variety of sources and combine to present a comprehensive summary.
5. Medical terminology required.
6. Must be proficient in computer skills including the ability to work with spreadsheet and word processing software.
7. Strong organizational and interpersonal skills.
8. Experience with conflict management.
9. Excellent verbal communication skills. Ability to independently write correspondence appropriate for mailing to patients and insurance companies or other third parties.
10. Ability to professionally represent the clinic’s interests and patient concerns with parties outside of the clinic setting.
11. Ability to provide leadership to others to accomplish a goal.
1. Ability to work various shifts between 7:30 a.m. and 5:30 p.m. including occasional overtime.
2. Ability to multi-task efficiently and effectively.
3. Must be able to act calmly and effectively in a busy or stressful situation.
4. Requires adherence to all policies and procedures, including standards for safety, attendance, punctuality and personal appearance.
5. Must be able to establish and maintain effective working relationships with managers and peers.
1. Hearing: Adequate to perform job duties in person and over the telephone.
2. Speaking: Must be able to communicate clearly to patients and coworkers in person and over the telephone.
3. Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.
4. Other: The position is mostly sitting with standing and walking occasionally throughout the day. Requires frequent lifting and carrying of items weighing less than 5 pounds and occasional lifting and carrying items weighing up to 10 pounds. Requires occasional bending and reaching.
The above is intended to describe the general content and requirements for the performance for this position. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.
THE DOCTORS CLINIC IS AN EQUAL OPPORTUNITY EMPLOYER