Patient Account Rep Level II

Regional One Health; Memphis (TN); On-site; USD 42,000 - 62,000; Full time

Job summary

Regional One Health is seeking a PFS Specialist to support billing, collections, and reimbursement processing in the Patient Financial Services department. You will handle incoming calls, gather account information, and ensure accurate, timely posting of payments and adjustments.

The role requires at least 2 years in facility reimbursement and experience with hospital billing or insurance collections. Strong customer service skills and attention to detail are essential in this fast-paced setting.

Qualifications

• Minimum 2 years experience in facility reimbursement (hospital billing, insurance collection, hospital payment validation)
• Experience with reimbursement verification and/or refunds for government and/or commercial insurances may be required
• College education or prior insurance experience may substitute for hospital experience

Responsibilities

• Answer incoming calls to PFS and return voicemails within set time period
• Monitor, follow up, and research assigned patient accounts to maintain accurate records
• Provide courteous, professional customer service at all times
• Review and resolve credit balances on patient accounts per PFS process
• Ensure daily productivity standards and timely documentation of actions
• Assist with charity applications by applying the current Federal Poverty Guidelines
• Collaborate with PFS Managers to address training needs and process improvements
• Attend daily team briefings and participate in performance metrics tracking

Skills

Customer service

Billing and collections

Medical billing

Data entry

Education

High School diploma or equivalent

College education

Tools

Insurance claim systems

Job description

Responsible for the accurate and timely processing of patient accounts related to billing, collections and reimbursements service for The Regional Medical Center in accordance with PFS standards, policies and procedures.Responsible for a variety of task to include manning of the PFS reception area. Demonstrates a level of accountability to ensure customer satisfaction. Gathers all information necessary to process patient billing and legal subpoenas requests. Ensures that daily productivity standards, credit resolutions and payment allocations are met to obtain the required completion rate.What you will doAnswer incoming calls to PFS. Ensures that all voicemails are retrieved and returned within set time period. Provides monitoring, follow-up, and research of all assigned patient accounts as required to maintain accurate records pertaining to patient and/or account information. * Provides courteous and professional customer service at all times. * Responds to patient and insurance company complaints, correspondence, inquiries and requests for billing related information. Ensures that all required financial/demographic information is secured. * Provides monitoring, follow-up, and research of all assigned patient accounts as required to maintain accurate records pertaining to patient and/or account information. * Provides courteous and professional customer service at all times.Review and resolve credit balances on patient accounts in accordance with PFS process. * Review credit balances to identify trends and develop resolutions. * Perform the necessary research to determine if credit is a refund or adjustment and proceed with the corresponding steps to resolve according to the PFS process agreement. * Provides continuous updates and information to PFS management regarding ongoing errors, payer related issues, registration issues and other controllable related activities affecting reimbursement and payment methodology.Maintains an active working knowledge of the current year Federal Poverty Guidelines as it pertains to approving charity applications. * Ensures all required documents and signatures are received as required. * Performs the necessary review to ensure charity approved patients billing reflects the correct balance. * Ensure proper documentation of accountsEnsures daily productivity standards are met. * Ensures all correspondence is worked and voicemails returned within 48 hours of receipt during work week. * Patient payments allocated accurately and timely * Ensures business service requests are worked and documented within 24 hours of receipt during workdays. Works all discount applicable generated reports, providing proper documentation and making necessary corrections within 48 hours of receipt during workdays.Ensures quality standards are met and proper documentation regarding patient accounting records. * Identifies and forwards proper account denial information to the designated departmental liaison. * Ensures proper billing record is submitted per subpoena request.Works collaboratively and cohesively with the team to assist in keeping workload evenly distributed. * Works with PFS Managers to assess the educational needs of associates and provides the necessary training and education on transactional processes. * Ensures consistent, open and honest communication with PFS Director and/or Managers regarding findings, recommendations and other financial opportunities. * Attends and participates in daily team briefings, metrics tracking and prompt resolution of Issues, Problems and OpportunitiesHigh School Diploma Or equivalent. RequiredMinimum 2 years experience Experience in facility reimbursement (hospital billing, insurance collection, hospital payment validation preferred) and reimbursement verification and/or refunds for government and/or commercial insurances. Required andCollege education, previous insurance company claims experience and/or health care billing experience may be considered in lieu of hospital experience. RequiredPhysical DemandsStanding - OccasionallyWalking - OccasionallySitting - ConstantlyLifting - RarelyCarrying - RarelyPushing - RarelyPulling - RarelyClimbing - RarelyBalancing - RarelyStooping - RarelyKneeling - RarelyCrouching - RarelyCrawling - RarelyReaching - RarelyHandling - OccasionallyGrasping - OccasionallyFeeling - RarelyTalking - ConstantlyHearing - ConstantlyRepetitive Motions - FrequentlyEye/Hand/Foot Coordination - FrequentlyRegional One Health is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.