Patient Account Representative

Pediatric Associates; Town of Florida (NY); Hybrid; USD 42,000 - 54,000; Full time

Job summary

Pediatric Associates, a healthcare provider, is seeking a Remote Patient Account Representative to handle guarantor intake and delinquent accounts, guiding payments and inquiries from patients across the United States.

Responsibilities include reviewing accounts, posting adjustments, and coordinating with management to resolve billing disputes while protecting PHI and maintaining high service levels in a remote setting.

Qualifications

• High School Diploma or equivalent.
• Minimum 1 year of customer service experience in a healthcare setting.
• Knowledge of billing and collection policies and processes.

Responsibilities

• Manage intake from guarantors and delinquent accounts to solicit payment.
• Monitor accounts and perform data entry, verification, coding and posting as instructed.
• Review accounts and make adjustments to ensure correct reimbursement.
• Identify delinquent accounts and set up payment plans or follow-up actions.
• Handle requests for medical records and explanations of benefits (EOB).

Skills

Billing policies

Insurance knowledge

Problem solving

Multi-tasking

Organizational skills

Communication

Teamwork

PC knowledge

Education

High School Diploma or equivalent

Tools

Microsoft Office

Email

Internet

Job description

Pediatric Associates was founded in Hollywood, FL in 1955. The same clinician-led, evidence-based, medical home passion is a unifying driver for those who join Pediatric Associates Family of Companies. The Pediatric Associates Family of Companies is a growing team of Pediatricians and Pediatric Care Teammates who are excited to be part of the first nationwide Pediatric Primary Care Medical Home. We further our uniqueness by ensuring the clinician voice is leading our medical home innovations.

Remote Opportunity for BILINGUAL Spanish/English Patient Account Representative

Schedule:Monday throughFriday 9:00am -6:00pm CST

PRIMARY FUNCTION

Patient Account Representative is responsible for managing and monitoring all tasks and communication related to the intake of information from guarantors and/or delinquent accounts to solicit payment. Other duties include: keeping records of collections and status of accounts, and taking incoming and make outbound calls to assist with patient account balances.

ESSENTIAL FUNCTIONS OF THE JOB

This list may not include all of the duties that may be assigned.

1. 1. Monitor queue to ensure calls are being handled professionally and appropriately.
2. 2. Perform analysis, research, and making decisions to appropriately handle phone inquiries.
3. 3. Review accounts and responsible for completing adjustments to ensure correct reimbursement as instructed by Manager.
4. 4. Identify delinquent accounts, aging period, payment sources, and correct any claim processing (data entry, verification, coding and/or posting) errors identified.
5. 5. Manage requests for medical records, correspondence, and/or Explanation of Benefits (EOB). Research proper processing and/or payment of accounts from patients with or without insurance.
6. 6. Responsible for collection efforts and for taking the appropriate steps to have claims processed for payment (i.e. re-submitting claims or filing claims appeal for payment or additional payment).
7. 7. Keeps Manager abreast of any changes, and documents any problems related to work methodology procedural and recommends actions.
8. 8. Identify and resolve patient billing disputes by evaluating patients’ financial status, establishing budget payment plans, collecting payments, and refunding patient credits.
9. 9. Demonstrate good judgement and reads and abides by the company’s code of conduct, ethics, employee handbook, policies and procedures and other corporate mandates.
10. 10. Accountable for limiting the use and disclosure of Protected HealthInformation (PHI) for patients and employees information to the Minimum Necessary in order to perform job.
11. 11. Other various duties as assigned, including cross-training in other functional areas.

Non patient-facing

PERFORMANCE REQUIREMENTS

Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI in accordance with organizational policy, Federal, State, and local regulations.

TYPICAL WORKING CONDITIONS

• Indoor Work
• Operating Computer
• Reach Outward
• Manual Dexterity
• Lift/Carry 10 lbs. or less
• Sitting

Other Physical Requirements

• Vision
• Sense of Sound
• Sense of Touch

EDUCATION

High School Diploma or equivalent required.

LICENSURE/CERTIFICATION

None

EXPERIENCE

Minimum 1 year of customer service experience in a healthcare setting required.

KNOWLEDGE, SKILLS & ABILITIES

• Knowledge of billing and collection policies and procedures, all types of insurance (HMO, PPO, POS, Medicaid etc.) Skill in defining problems, interpreting billing information.
• Ability to multi-task in a face paced environment while meeting established production and quality goals/metrics.
• Strong organizational skills, with ability to effectively prioritize work and daily basis and follow up on open items in a timely manner.
• Must have strong verbal, written, and interpersonal communication skills
• Demonstrates ability to work well in a team environment.
• General PC knowledge including Microsoft Office, Internet and Email.