JOB DESCRIPTION
Job Title
Patient Account Representative
FLSA
Non-Exempt
Reports to
Manager, RCM
Grade
D
Location
Remote
Band
1A
Summary/Objective
Under supervision, the Patient Account Representative will be responsible for effectively communicating with patients to explain medical billing and insurance claims, resolve inquiries, and ensure timely payment collection.
Essential Job Functions
Handle inbound and outbound patient calls to address medical billing statements, insurance claims, payment collection, and related financial matters.
Explain billing processes, insurance coverage, and payment options to patients in a clear and concise manner.
Provide outstanding customer service by addressing patient inquiries, resolving billing discrepancies, and answering questions regarding insurance benefits and claim status.
Verify patient demographic and insurance information, ensuring accuracy and making necessary updates as required.
Update patient accounts with relevant information obtained during phone conversations, including payment arrangements, financial assistance applications, or any other relevant documentation.
Work closely with insurance companies, coding specialists, and other team members to resolve any claim denials or issues impacting patient payments.
Assist patients in understanding and navigating the process for filing insurance claims and submitting necessary documentation.
Educate patients on financial assistance programs, payment plans, and available resources for managing medical expenses.
Document all communication with patients accurately and thoroughly in the appropriate systems or databases.
Attend various meetings virtually such as team meetings, training meetings, one-on-one meetings, etc.
Adhere to company policies, procedures, and regulatory guidelines to ensure compliance with patient privacy (HIPAA) and collection practices.
Performs other duties as directed.
Perform duties in compliance with Company's policies and procedures, including but not limited to those related to HIPAA and compliance.
Key Success Indicators/Attributes
Ability to prioritize and multi-task in a fast-paced, changing environment.
Demonstrate ability to work in all work types and specialties.
Demonstrate ability to self-motivate, set goals, and meet deadlines.
Demonstrate problem-solving skills and the ability to think critically to identify and implement appropriate solutions.
Demonstrate excellent verbal communication skills, with the ability to effectively explain complex billing and insurance concepts to patients.
Strong active listening skills to understand patient concerns and provide appropriate resolutions.
Maintain courteous and professional working relationships with employees at all levels of the organization.
Work in accordance with corporate and organizational security policies and procedures, understand personal role in safeguarding corporate and client assets, and take appropriate action to prevent and report any compromises of security within scope of position.
Ability to remain calm and composed in stressful situations, and effectively de-escalate any conflicts or disputes.
Compassionate and empathetic personality to handle patient inquiries and concerns with sensitivity and professionalism.
Skill in operating a personal computer and utilizing a variety of software applications is essential.
Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation is an added advantage.
Supervisory Responsibility
No
Work Environment
This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and soft phones.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.
Position Type/Expected Hours of Work
This is a full-time position. Each employee's schedule must be between the hours of 6:00 AM PST to 9 PM PST, Monday through Friday with the specific schedule for each employee to be agreed upon by the employee's manager and the employee, taking into account the needs of the client. This position occasionally requires long hours and weekend work.
Travel
None
Required Education and Experience
Minimum of 1-2 years prior experience/knowledge of medical billing processes, insurance terminology, and reimbursement practices.
Proficient computer skills and experience with electronic health records (HER) or billing software systems.
High School diploma or equivalent, additional education in healthcare administration or related field is a plus.
Proven experience in a customer service or call center role, preferably within the healthcare industry.
Preferred Education and Experience
N/A
Additional Eligibility Qualifications
N/A
Security Access Requirements
In addition to the specific security access required by the employee's client engagement, the employee will have access to the Omega set forth in the "Standard Field Employee" profile.
Microsoft Office
ADP
Oracle
E1- Field Employee
Standard Employee
Standard
Equal Employment Opportunity:
Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.
Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.
Founded in 2003, Omega Healthcare Management Services (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com
We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.
AAP/EEO Statement
Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.
Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com.
Qualifications
Education: High School Diploma or equivalent work.
Experience:
Minimum:
2-3 years of experience in a customer
service call center environment
Ability to use de-escalation practices for
escalated disputes.
Ability to understand and apply guidelines,
policies and procedures.
Must possess the ability to read, write and
communicate in English.
Ability to communicate effectively both
verbally and in writing.
Data entry skill level- minimum of 40-50
WPM preferred.
Preferred:
Medical billing experience
Bi-lingual
Prior experience in a third-party
collection or medical collections and
knowledge of industry terminology,
principles and procedures is highly
preferred.
Certifications: None
Knowledge/Skill:
Interpersonal skills
Basic computer skills
Motivation Teamwork Customer/Patient
focused Professionalism
Organizational skills
Requires knowledge of state and federal
healthcare laws and regulations.
Strong attention to detail and accuracy.
Ability to learn and master multiple
computer and phone systems quickly.
Requires highly developed communication
skills to effectively work with all levels of
management throughout the UnityPoint
Health, its subsidiaries and affiliates.
Preferred:
Knowledge of DRG's, Revenue Codes,
CPT/HCPC Codes, modifier assignment
and government rules/regulations for
inpatient and outpatient hospital billing,
skilled nursing billing, inpatient rehab
and inpatient psych.
Other Preferred:
2 Years of Epic
1 Year of Denials/Appeals and/or Account Resolution