Patient Account Representative-Medical Billing

Summit BHC•Oakland, CA

About The Position

About the Job: The Patient Account Representative is responsible for financial assessment of patients, determination of ability to pay, collection of deposits, negotiation of payment arrangements, securing financing of self-pay liability, and identification of funding sources.

Requirements

High school diploma or equivalent required.
Two or more years’ prior admissions, collections experience and requests for verification of benefits in a hospital setting required.

Nice To Haves

Psychiatric experience preferred.

Responsibilities

Verifies benefits on each admission and appropriately documents billing system of patient’s financial obligations.
Provides financial counseling for patients (or responsible parties) of their financial obligations including education/consent of private pay agreement, explanation of benefits, co-pays and deductible information, etc. to patients and families to assist patients in identifying funding sources; Performs upfront collections when appropriate.
Collects data and compiles various/ongoing reports to record and monitor upfront collection data.
Responds to all requests for insurance benefit verification in a timely manner to facilitate admission.
Completes documentation of all benefit and eligibility information with accuracy and detail and communicates timely to designated staff. Reviews explanation of benefits to ascertain that claim is processed and paid correctly.
Accurately determines third party and self-pay liability. Verifies benefits, anticipated length of stay, average program cost to establish correct liability.
Prepares written out of pocket estimates and discusses with patient and/or family.
Ensures all patients are “financially secured” as soon as possible but no later than at discharge.
Requests credit reports to assist in determining collectability.
Collects “Advance Payments” according to guidelines provided.
Reviews claims issues utilizing claims clearing house and make corrections as needed and rebill.
Completes adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.
Manages daily productivity via patient accounting system and productivity reports.
Prorates patient accounts and monitors that balance due is in the correct financial class.
Maintains appropriate reminder system for follow-up activity.
Gathers and interprets data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.
Completes monthly re-verification of all current, in-house patients.