Patient Account Rep

Central Florida Health Care•Winter Haven, FL

1d•Hybrid

About The Position

The Managed Care Patient Account Representative is responsible for coordinating all aspects of completing referrals ordered by CFHC providers. This includes obtaining appropriate authorizations from insurance companies, scheduling referral appointments, and tracking all referrals to ensure quality and continuity of care. The role requires knowledge of medical terminology, billing practices, and electronic health records, along with strong problem-solving and communication skills.

Requirements

Minimum of 1-3 years healthcare experience working in a managed care, revenue cycle or billing office setting.
Knowledge of medical terminology or concepts is a must.
Proficiency in Microsoft Office applications including Word, Power Point, Excel, and Outlook is a must.
High school graduate or equivalent required.
Electronic Health Records Knowledge.
Knowledge of billing practices and billing office functions required.
Knowledge of medical records, EHR required.
Must have good math skills.
Must have effective communication skills.
Must have good problem-solving skills.

Nice To Haves

FQHC preferred

Responsibilities

Coordinate all aspects of completing referrals ordered by CFHC providers.
Complete referrals in a timely manner (STAT referrals by end of business day, URGENT within 24 hours, ROUTINE within 72 hours).
Obtain appropriate authorizations from insurance companies by sending necessary documentation from the patient’s medical record.
Schedule referral appointments for patients, ensuring proper paperwork is faxed to the specialist or given to the patient.
Notify patients of scheduled referral appointments.
Document appropriately and thoroughly.
Track all referrals to improve the quality and continuity of care, including initiating reminder calls and obtaining referral reports from specialists.
Notify the ordering provider and/or Referral Specialist Supervisor of any problems in obtaining a patient’s referral.
Maintain a specialty provider list including payor sources they accept.
Review referral log weekly to ensure completion of all referrals.
Be familiar with CFHC’s program philosophies, goals and objectives.
Be cognizant of and comply with all CFHC’s policies and procedures, as well as state and federal regulations.
Be competent in performing the duties of a referral specialist.
Report as needed to CMO any pertinent information or situations that impact on patient care or CFHC liability.
Attend and participate in mandatory CFHC meetings.
Demonstrate ability to work cooperatively with other members of the clinical team.
Be supportive of coworkers.
Maintain a neat and professional appearance at all times.
Carry out any other activities deemed appropriate by the CMO or CEO.
Other duties as assigned by Referral Specialist Supervisor.