Patient Account Representative 4 - Hospital

FMOL Health; Baton Rouge (LA); On-site; USD 42,000 - 54,000; Full time

Job summary

FMOL Health is seeking a Patient Accounts Representative 4 to support the revenue cycle. The role focuses on customer service, billing and collection functions within the Business Office, handling balances, credits, and denials with managed care providers.

Strong knowledge of EPIC, and a background in hospital billing and insurance follow-up will be essential. This position requires collaboration with internal teams and adherence to FMOLHS policies and performance standards.

Qualifications

• 8 years experience in Revenue Cycle / Hospital Business Office programs (Customer Service, Billing, Follow-up) or equivalent industry experience.
• Bachelor's Degree can substitute for 4 years of experience; Associate's Degree can substitute for 2 years of experience.
• High School diploma or equivalent
• Must possess knowledge of ICD-9/10, CPT and HCPCS coding.
• Apply critical thinking and problem solving skills as it relates to resolving accounts.

Responsibilities

• Coordinate with patients, co-workers and external agencies to ensure prompt payment and/or reimbursement of hospital and professional charges.
• Manage collections on delinquent insurance and patient balances.
• Post payments and adjustments; file claims and appeals denials with managed care companies.
• Review accounts in EPIC system and provide information requested to resolve issues.
• Collaborate with leadership to identify opportunities for improvements and SME support to team members.

Skills

Customer service

Billing

Follow-up

Accounts reconciliation

Education

High School diploma or equivalent

Bachelor's degree substitute for 4 years of experience

Associate's degree substitute for 2 years of experience

ICD-9/10 CPT HCPCS coding knowledge

Tools

EPIC system

Job description

The Patient Accounts Representative 4 performs an important function in the revenue cycle of the Health System. This role is production based and works an assigned queue to coordinate with patients, co-workers and external agencies to ensure the prompt payment and/or reimbursement of hospital and professional charges. The Patient Accounts Representative is responsible for the customer service, billing and collection functions in the Business Office. Key tasks include reviewing accounts on EPIC system, providing information requested and applying critical thinking to resolve issues between balances and/or credits belonging to managed care vs the patient. This role responsible for collections on delinquent insurance and patient balances and for working credit balance reports, posting payments and adjustments, and filing claims and appeals denials with managed care companies. Must meet minimum performance and quality measures. This role is leverages years of experience to handle more complex scenarios and provides SME support to other team members, as well as collaborating with leadership to identify opportunities for improvements.

• 8 years experience in Revenue Cycle / Hospital Business Office programs (Customer Service, Billing, Follow-up) or equivalent industry experience.
• Related certification program in areas such as billing, medical office, coding and accounting can be substituted for 1 year of experience.
• Bachelor's Degree can substitute for 4 years of experience; Associate's Degree can substitute for 2 years of experience.
• High School diploma or equivalent
• Must possess knowledge of ICD-9/10, CPT and HCPCS coding.
• Apply critical thinking and problem solving skills as it relates to resolving accounts.
• Must understand the explanation of benefits of various managed care companies and regulations.
• Must be able to demonstrate teamwork and willingness to work in cooperation and support of others as well as comply with FMOLHS policies, procedures and core values.
• Communication, interpersonal and collaboration skills.