Patient Accts Rep Hospital - Full Time - Days

Crisp Regional Health Services; Cordele (GA); On-site; USD 38,000 - 52,000; Full time

Job summary

Crisp Regional Health Services in Cordele, GA seeks a Patient Account Representative to join the Patient Financial Services team. You will manage a group of accounts, ensure billing accuracy, and submit electronic claims within established timeframes.

The role requires a high school diploma (Associate's in Accounting preferred) and 1–2 years in accounting or healthcare billing; CPAR or Billing Specialist certification preferred. You will work under HIPAA guidelines and support collections.

Qualifications

• Education requirements include a high school diploma or GED; an Associate’s degree in Accounting is preferred.
• Experience: 1–2 years in accounting or bookkeeping; healthcare accounting preferred.
• Billing certifications such as Billing Specialist Certification or CPAR are preferred.

Responsibilities

• Maintain and control an assigned section of patient accounts with accuracy.
• Review files daily, verify demographics and insurance data prior to claims submission.
• Prepare and submit claims to carriers within 24 hours of information availability.
• Monitor accounts for follow-up with insurers or employers as needed.
• Respond to patient, insurer, or third-party inquiries about benefits and balances.
• Ensure HIPAA privacy compliance and CRHS policies in all activities.
• Back up Hospital Financial Counselor/Business Office Cashier as needed.
• Prepare reports and ensure accounting entries follow GAAP and policy.

Skills

Accounting

Detail-oriented

Education

High school diploma or GED

Associate’s degree in Accounting (preferred)

Tools

eSolutions

AllScripts

Job description

Position Summary

Under the leadership of the Director, Patient Financial Services, the Patient Account Representative is an active member of the Patient Accounting team that delivers professional accounting services and support that is consistent with the strategic vision, goals, philosophy, and direction of Patient Accounting and CRHS. The Patient Account Representative works with an assigned group of accounts to ensure the accuracy and completeness of billing amounts and patient information. The Representative processes electronic claim submissions for payment within established timeframes and tracks payments as necessary. This position works with appropriate parties to remedy past due accounts and process deposits payments received.

Position Summary

Under the leadership of the Director, Patient Financial Services, the Patient Account Representative is an active member of the Patient Accounting team that delivers professional accounting services and support that is consistent with the strategic vision, goals, philosophy, and direction of Patient Accounting and CRHS. The Patient Account Representative works with an assigned group of accounts to ensure the accuracy and completeness of billing amounts and patient information. The Representative processes electronic claim submissions for payment within established timeframes and tracks payments as necessary. This position works with appropriate parties to remedy past due accounts and process deposits payments received.

Basic Qualifications

• Education: Requires a high school diploma with an emphasis in Office Occupations or a GED state certification. An Associate’s degree in Accounting is preferred.
• Experience: Requires one to two years of work-related experience in accounting or bookkeeping or any equivalent combination of education, training, and experience. Experience in healthcare-related accounting or bookkeeping is preferred.
• Licensure, Registrations & Certifications: Billing Specialist Certification or Patient Account Representative certification (CPAR) preferred.

Essential Job Responsibilities

• Alerts Billing Manager to any potential biller or payer issues
• Assists billing manager with performance evaluation of billing staff
• Maintains and controls an assigned section of patient accounts.
• Reviews files daily and checks final amounts for accuracy and completeness, verifies and edits patient demographic and insurance information prior to claims submission.
• Ensures the accuracy of accounting for all accounts.
• Records late charges on patient accounts for appropriate logs.
• Enters required UB92 and/or physician billing 1500 information, or other pertinent information not in the system for electronic transmission of insurance claims.
• Prepares and submits claims to carriers and intermediaries within 24 hours after all information is available for billing.
• Monitors accounts for trace follow-up to insurance company and/or employer when necessary.
• Processes and responds to correspondence from patients, insurance companies or third parties regarding insurance benefits, unpaid claims, and account balances.
• Complies with all CRHS privacy policies and procedures including those implementing the HIPAA Privacy rule.Contacts patient account guarantors by telephone or mail to secure contracts or collection of payments.
• Reviews accounts records and ensures that collection letters are sent and debtors are contacted according to established hospital policy.
• Monitors collection agency reports and remittances for accuracy.
• Follows established procedures for collecting NFS check returns.
• Resolves payment problems with patients and third party payers.
• Reviews account status for referral to outside collection agencies prior to write off.
• Ensures the effective billing for accounts queued in other web based software (eSolutions, etc.) and other billing solutions (AllScripts, etc.) or other various billing applications.
• Serves as a back-up for the Hospital Financial Counselor/Business Office Cashier.
• Prepares reports or statistics as required.
• Ensures that accounting entries are made according to generally accepted accounting principles and CRHS policy.
• Complies with all CRHS privacy policies and procedures including those implementing the HIPAA Privacy rule.
• Attends in-service training, education programs and meetings as required or directed.
• Adheres to established CRHS and departmental policies, procedures and objectives for quality assurance, safety, environmental, and infection control.
• Performs other related job duties as assigned.