Patient Account Representative 2 - Hospital

FMOLHS; Oregon (WI); On-site; USD 40,000 - 55,000; Full time

Job summary

A healthcare organization seeks a Patient Accounts Representative 2 to manage patient accounts, ensuring timely payments and reimbursements. Responsibilities include handling inquiries, monitoring claims, and coordinating with various stakeholders. The ideal candidate will have at least 2 years of relevant experience or applicable degrees. Knowledge of healthcare coding (ICD-9/10, CPT) and strong data entry skills are essential for this role. This position is crucial in assisting patients with their financial responsibilities related to healthcare services.

Qualifications

• Must have 2 years of relevant experience or a Bachelor's Degree substituting for 2 years.
• Relevant experience includes roles like LPN, RN, Revenue Cycle, Accounting, Bookkeeping, Billing, or Coding.
• Must possess knowledge of ICD-9/10, CPT, and HCPCS coding. Must have accurate data entry skills.

Responsibilities

• Work with patients to ensure prompt payment and/or reimbursement of charges.
• Monitor patient accounts, including claim submissions and researching denials.
• Answer inquiries from patients regarding their accounts.

Job description

LA, United States

Job Description

The Patient Accounts Representative 2 works with patients, co-workers and external agencies to ensure the prompt payment and/or reimbursement of hospital and/or professional charges. The Patient Accounts Representative 2 is responsible for the monitoring of patient accounts which includes, but is not limited to: claim submissions, researching and reviewing back end denials; determining appropriate action for submission of provider claims; outbound and inbound calls from insurance carriers, providers and patients; payment posting; collections; account adjustments and appeals.

Responsibilities

• Customer Service
  • Promptly answers inquiries from patients, co-workers, and employees regarding patient accounts in a kind and courteous manner.
  • Assists in providing quality training and orientation for assigned employees.
• Payer Relations
  • Advises patient or guarantor of third party payer benefits and estimated private payer amount and collects partial payments prior to admission in a manner that promotes the provision of high quality health care services by the department.
  • Reviews patient papers and documentation for reported information accuracy, and researches errors on patient accounts, billing and insurance problems, and lost payments in order to ensure accurate record maintenance and prudent departmental operation.
  • Makes written and verbal inquiries to third party payers, reconciles patient accounts, and makes payment arrangements in an effort to ensure that patients are free from financial burden and that patient interests are appropriately represented.
  • Coordinates and originates payroll deduction actions for hospital employees in accordance with established policies and procedures, and oversees collection letter mail-outs for delinquent unpaid patient accounts in a prudent and efficient manner.
  • Sends itemized patient account statements per attorney request or in response to subpoena in a professional and diligent manner.
  • Reviews claims to make sure that payer specific billing requirements are met.
  • Follows up on claims, determines and applies appropriate adjustments.
  • Updates accounts.
• Receivables
  • Works with external agencies and companies to provide patients with prompt reimbursement for hospital services. Interprets, explains, and counsels patient and family regarding hospital charges, services, and payment policies in a manner sensitive to the needs and financial situation of the patient.
• Quality
  • Maintain a quality accuracy average of 95%
  • Maintain a production set by management for specialty focus.
  • Thoroughly completes assigned tasks with in the requested timeline.
• Other Duties As Assigned
  • Performs other duties as assigned or requested.

Qualifications

• Must have 2 yrs experience of relevant experience. Bachelor's Degree substitutes 2 yrs exp. Associate's Degree, trade school, or certification substitutes 1 yr exp.
• Some examples of relevant experience include LPN, RN, Revenue Cycle, Accounting, Bookkeeping, Business, Billing, Coding or call center environments.
• High School or equivalent
• Must possess knowledge of ICD-9/10, CPT and HCPCS coding. Must have accurate data entry skills. Must be able to answer multiple phone lines with incoming and outgoing calls. Must understand the explanation of benefits of various managed care companies. Must be able to demonstrate teamwork and willingness to work in cooperation and support of others as well as comply with FMOLHS policies and procedures.