Patient Account Representative- Full Time

Summit BHC; Raleigh (NC); On-site; USD 38,000 - 52,000; Full time

Job summary

Raleigh Oaks Behavioral Health, part of Summit BHC, seeks a Patient Account Representative to manage financial assessments, verify benefits, and coordinate payments for patients at Garner, NC. The role focuses on upfront collections, benefit verification, and ensuring accurate liability calculations within a hospital setting.

The successful candidate will have 2+ years in admissions/collections, experience with hospital billing systems, and strong communication skills to educate patients on

Qualifications

• High school diploma or equivalent required.
• Two or more years’ admissions, collections experience and verifications in a hospital setting required.
• Experience with online Admission/Billing systems desirable.

Responsibilities

• Verifies benefits on each admission and documents patient billing obligations.
• Provides financial counseling to patients and families about private pay, co-pays and deductibles.
• Collects data and compiles reports on upfront collection data.
• Responds to insurance benefit verification requests to facilitate admission.
• Documents benefit and eligibility information accurately and communicates with staff.
• Determines third party and self-pay liability and analyzes expected length of stay and program costs.
• Prepares written out-of-pocket estimates and discusses with patients or families.
• Ensures patients are financially secured by discharge.
• Gathers data and initiates time-sensitive collection actions to secure payment.
• Monitors daily productivity and manages patient accounting system.

Skills

Financial counseling

Collections

Admission/Billing knowledge

Education

High school diploma or equivalent

Tools

Online Admission/Billing system

Job description

Patient Account Representative- Full Time | Raleigh Oaks Behavioral Health | Garner, North Carolina

About the Job:

PURPOSE STATEMENT:

The Patient Account Representative is responsible for financial assessment of patients, determination of ability to pay, collection of deposits, negotiation of payment arrangements, securing financing of self-pay liability, and identification of funding sources.

Roles and Responsibilities:

ESSENTIAL FUNCTIONS:

• Verifies benefits on each admission and appropriately documents billing system of patient’s financial obligations.
• Provides financial counseling for patients (or responsible parties) of their financial obligations including education/consent of private pay agreement, explanation of benefits, co-pays and deductible information, etc. to patients and families to assist patients in identifying funding sources; Performs upfront collections when appropriate.
• Collects data and compiles various/ongoing reports to record and monitor upfront collection data.
• Responds to all requests for insurance benefit verification in a timely manner to facilitate admission.
• Completes documentation of all benefit and eligibility information with accuracy and detail and communicates timely to designated staff. Reviews explanation of benefits to ascertain that claim is processed and paid correctly.
• Accurately determines third party and self-pay liability. Verifies benefits, anticipated length of stay, average program cost to establish correct liability.
• Prepares written out of pocket estimates and discusses with the patient and/or family.
• Ensures all patients are “financially secured” as soon as possible but no later than at discharge.
• Requests credit reports to assist in determining collectability.
• Collects “Advance Payments” according to guidelines provided.
• Reviews claims issues utilizing claims clearing house and make corrections as needed and rebill.
• Completes adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.
• Manages daily productivity via patient accounting system and productivity reports.
• Prorates patient accounts and monitors that balance due is in the correct financial class.
• Maintains appropriate reminder system for follow-up activity.
• Gathers and interprets data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.
• Completes monthly re-verification of all current, in-house patients.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• High school diploma or equivalent required.
• Two or more years’ prior admissions, collections experience and requests for verification of benefits in a hospital setting required. Psychiatric experience preferred.
• Prior experience with on-line Admission/Billing system desirable.

LICENSES/DESIGNATIONS/CERTIFICATIONS:

Not applicable.

WORK LOCATION:

This position is onsite and is not a remote position.

SUPERVISORY REQUIREMENTS:

This position is an Individual Contributor.

Why Raleigh Oaks Behavioral Health?

Raleigh Oaks Behavioral Health offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Raleigh Oaks Behavioral Health is an EOE.

Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.