Patient Accounts Rep- Full Time - Days

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:

• 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.
• Contacts patient account guarantors by telephone or mail to secure contracts or collection of payments.
• Assists with the process of filing liens, garnishments or initiates other legal action to remedy unpaid accounts.
• Reviews accounts record 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.
• Deposits daily receipts with Business Office Accounts Receivable staff and ensures cash funds are reconciled.
• 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