Patient Account Representative/Inpatient Insurance Specialist

Siskin Hospital for Physical Rehabilitation; Chattanooga (TN); On-site; USD 35,000 - 50,000; Full time

Job summary

A rehabilitation facility in Chattanooga is seeking a Patient Accounts Representative to manage communications with payers, resolve claims, and ensure the accuracy of accounts receivable. The successful candidate should have strong communication skills and at least one year of experience in a healthcare setting. Responsibilities include maintaining patient accounts, analyzing payment denials, and posting payments. Candidates with certification in a medical or business-related field are preferred. This role offers full-time employment with opportunities for professional growth.

Qualifications

• Minimum one year experience in the healthcare field.
• Prefer one year experience in healthcare accounts receivable management.
• Typing and data entry at a minimum of 40 wpm.

Responsibilities

• Communicate with payers to resolve claims and collect revenues.
• Maintain accurate and current accounts receivable.
• Analyze explanations of benefits and denials from third-party payers.

Skills

Communication skills

Data entry

Healthcare knowledge

Prioritization

Education

Certification in medical or business-related field

Tools

Word processing software

Job description

Under the direction of the Business Office Manager, the Patient Accounts Representative is the primary individual responsible for timely and accurately communicating with payers to resolve claims and collect revenues billed. Functions relating to patient accounts include:

Maintaining accurate and current accounts receivable, timely follow-up and collections, effective communication with third party payers, patients and internal personnel associated with precertification, re-certification, medical records and clinical services staff in collecting and/or resolving accounts receivable issues. Serve as primary contact relating to financial and insurance reimbursement/patient responsibility counseling as it relates to resolution/compliance on accounts, assist in posting/reconciling payments as needed, analyze explanations of benefits (EOB’s)/remittance advices (RA’s) and denials from third party payers for corrections/reimbursement accuracy and/or errors/changes. Inpatient Insurance Specialist functions include effective communication with insurance companies, Siskin discharge planners and others relating to certification of ongoing treatment by patients’ insurance plans, maintaining complete records to document approvals/denials in order to obtain correct reimbursement from third party payers.

SCOPE OF AUTHORITY / LEADERSHIP RESPONSIBILITY / REPORTING RELATIONSHIPS / IDENTIFICATION OF WORK TEAM

No supervisory responsibility. Work team shall include, but not be limited to, patient financial services, data entry, admissions/referral and inpatient/outpatient case management and clinical/medical staff.

PATIENT HEALTH INFORMATION – Access Level

Clinical—within work area; Financial—within work area

MINIMUM QUALIFICATIONS OR EQUIVALENTS (education, experience, licensure, certification, and/or specific skills)

Education: Certification in medical or business-related field or equivalent combination of post‑high school education and work experience.

Experience: Minimum one (1) year experience in the healthcare field with experience in a hospital, ambulatory, medical or rehabilitation setting. Prefer one (1) year experience in healthcare accounts receivable management (pre‑certification, re‑certification, collection of data/money, admissions/discharge process, patient financial services, insurance company and/or equivalent.

Licensure/Certification: As applicable to above.

Technical: Typing and data entry at a minimum of 40 wpm.

Exposure/experience with word processing software.

Knowledge of healthcare environment.

Ability to prioritize and respond to multiple requests.

Ability to disseminate and relay medical terms, conditions and processes according to protocol.

Strong written and verbal communication skills.

PHYSICAL/MENTAL REQUIREMENTS

Strength – Position requires the ability to occasionally lift light objects.

Manual dexterity – Position requires incumbent to constantly perform simple manipulative skills such as copying, filing, collating, stapling and moderately difficult manipulative skills such as typing and data entry.

Coordination – Position requires incumbent to constantly perform tasks which require hand‑eye coordination such as typing and data entry.

Mobility – Position requires incumbent to constantly be able to sit for prolonged periods.

Visual discrimination – Position requires the ability to read a computer screen, financial reports and other correspondence.

Hearing – Position requires the ability to hear normal sounds in a background with some noise, such as answering the telephone while a printout is in progress.

Concentration – Position requires the ability to concentrate on fine detail, such as when entering charges into the computer, with some interruption.

Attention span – Position requires ability to understand and relate to specific ideas, often several at once.

Memory – Position requires ability to constantly remember multiple tasks and assignments given to self and others over both a full shirt as well as a period of time extending several days.

ENVIRONMENTAL AND WORKING CONDITIONS

Employee may be constantly exposed to dust and electromagnetic radiation as in CRT’s.

Employee may be occasionally exposed to loud or unpleasant noises.

Employee may be working in close proximity with others.