PATIENT ACCOUNT REP Full Time Days

01 ETCH East Tennessee Children's Hospital Association, Inc.; Koppel (Beaver County); On-site; USD 36,000 - 54,000; Full time

Job summary

Dolly Parton Children’s Hospital is seeking an experienced insurance billing specialist to ensure accurate hospital billing and timely collection of receivables. You will work closely with families, verify insurance coverage, and help resolve questions while supporting a cooperative revenue cycle team.

The role emphasizes attention to CMS rules, coordination with payers, and professional communication with families and internal departments to optimize first-time claim submission and collections.

Qualifications

• High school diploma or GED required.
• Experience in hospital billing and collections preferred.
• Familiarity with CMS rules and third-party payer processes.
• Strong customer service and teamwork abilities.

Responsibilities

• Processes all hospital bills on receipt.
• Follows up on accounts according to department guidelines.
• Works insurance rejections promptly and accurately.
• Collaborates with UM, Medical Records and ancillary staff for a smooth revenue cycle.
• Maintains clear, shareable account notes suitable for families or legal use.
• Maintains confidentiality of patient information and handles sensitive data.

Skills

Customer service

CMS regulations

Insurance coordination

Problem solving

Education

High School Diploma / GED

Job description

BASIC PURPOSE OF THE JOB

Responsible for accurate billing and collection of hospital Receivables. Works closely with families to address questions/concerns and ensures proper insurance coverage for child. Gives feedback to team leader on ways to improve daily processes and improve collections. Able to work in a team environment and problem solve. Ensures clean claims and timely follow up with insurance companies.

REPORTS TO

Lead Inpatient Account Rep/ Lead Outpatient Account Rep

JOB REQUIREMENTS

• Supervisory Responsibilities: No Minimum Education: High School Diploma/GED required.
• Degree: General License/Certification Required: None
• Minimum Work Experience: Hospital billing and collection experience preferred.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

• Excellent customer service skills and ability to work well with a team required.
• Familiar with rules and regulations of CMS and other third party payers to ensure proper collection of insurance data to finalize claims for proper billing to proper payer on first time claim submission.
• Ability to work with insurance companies to ensure timely payment of claims.
• Problem solving skills required.

DUTIES AND RESPONSIBILITIES

• Processes all bills on the day they are received.
• Follows up on accounts based on Departmental guidelines.
• Works all insurance rejections in a timely manner.
• Works effectively with UM, Medical Records and ancillary department staff to ensure a seamless process flow between departments and the revenue cycle.
• Creates team environment with other departments to problem solve issues
• Documents accounts properly, with notes being of a nature that they could be shared as part of a legal document or with the family.
• Attends all required safety training and CBL requirements.
• Provides examples for teachable moments for registration staff and coworkers.
• Maintains professional composure and confidence during stressful situations
• Patient/Family Complaints are handled in a confidential, timely and professional manner, ensuring confidentiality of all hospital and patient information at all times as observed by management and peers.
• Continuously displays a “can do” attitude within the department and across department lines to contribute to the overall focus on service excellence at the hospital.
• Identifies problems, offers solutions, and communicates with Management as needed.
• Works as efficiently as possible to ensure best use of time in account short staffed for the day, major problems with billing etc.
• Utilizes hospital resources and time respectfully and accountably.
• Willingly accepts any other assignment that may be requested.

PHYSICAL REQUIREMENTS

Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position. Light lifting, pushing and pulling is required for 1-20 lbs occasionally and frequent moving of objects of less than 10 lbs is required. Frequent sitting with some walking, standing, squatting, bending, and reaching is required. Keyboard/computer use and/or repetitive motions may be required.

Come work where you can make a difference everyday. At Dolly Parton Children’s Hospital, care is at the CORE of who we are. We are comprised of team members who live out our core values of Compassion, Ownership, Respect, and Excellence. We support each other by fostering a culture of team engagement that creates moments that matter – every interaction, every time. Compassion – We imagine what others are going through, work to alleviate suffering, and create joy whenever possible. Ownership – We take pride in our work, act with integrity, and feel personal responsibility for achieving our mission. Respect – We listen, understand, and communicate openly and politely. We recognize our diverse strengths. Excellence – We set high standards for performance in delivering the safest patient care. We give extraordinary and meaningful experiences to our patients, their families, team members, and the community we serve.