PATIENT ACCOUNT REP Full Time Days

East Tennessee Children's Hospital; Koppel (Beaver County); On-site; USD 38,000 - 54,000; Full time

Job summary

East Tennessee Children's Hospital is seeking an Account Representative to accurately bill and collect hospital receivables, working with families to resolve questions and ensure proper insurance coverage.

You will collaborate with teams to maintain clean claims, follow up with insurers, and keep documentation for potential audits. Strong customer service and teamwork are essential in this role.

Qualifications

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

Responsibilities

• Process all bills on the day they are received.
• Follow up on accounts based on Departmental guidelines.
• Work all insurance rejections in a timely manner.
• Collaborate with UM, Medical Records and ancillary departments to ensure seamless revenue cycle flow.
• Document accounts with notes suitable for sharing in a legal context or with families.

Skills

Customer service

CMS rules

Insurance data

Problem solving

Education

High School Diploma

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.