Patient Account Representative

UMC Health System•Richmond, KY

1d•Onsite

About The Position

This role is responsible for managing in-network and out-of-network patient accounts according to third-party payer rules and MTALA regulations. The position requires knowledge of medical and third-party payer terminology, strong communication skills, mainframe computer proficiency, basic accounting and clerical skills, and excellent customer relations. The Patient Account Representative will work to ensure departmental cash collection goals are met or exceeded, handle credit balances, and manage assigned hold bills and problem visits. This role also involves documenting account activity, requesting additional information from patients when necessary, processing refunds, and assisting with the Credit Balance report. A key aspect of the role is accurately identifying the correct Financial Service Code/Plan for visits and ensuring accounts are billed correctly, with a focus on proactive education to departments regarding accuracy.

Requirements

High school graduate or equivalent required
Ability to communicate both verbally and in writing
Computer skills
Basic accounting and detailed clerical skills
Highly technical and problem-solving skills
Ability to handle change within the workplace
Adequate hand/eye coordination and fine motor skills required for typing.
Verbal communication and hearing are essential in dealing with co-workers and customers.

Nice To Haves

Some college preferred

Responsibilities

Manage and have knowledge of all contracts particular to your desk.
Determine if correct reimbursement has been submitted by the payer and/or if credit is due to incorrect proration.
Use the correct transaction codes when adjustments are required on a visit.
Work all mail received within 48 hours from the received stamped date.
Inform Supervisor or Director of large dollar adjustments, at least weekly, utilizing the high dollar adjustment spreadsheet. Documentation is required either in NB or as a comment on the transaction adjustment.
Work as a team member to ensure departmental cash collections goals are met or exceeded; this includes proper handling of credit balances.
Work all hold bills assigned to you in a timely manner.
Inform your Supervisor or Director of any reoccurring problems or issues immediately.
Run your ATB twice a month to check for problem visits.
Follow-up on visits that have no follow-up activity after the 28th date of the visit being billed.
Document your work in Notes B consistently and in detail for all accounts worked.
Utilize letters requesting additional information from the patient or insured only when unable to reach by phone or calls are unreturned, to ensure claims are billed and paid timely.
Work all refunds promptly, and keep the Refund worklist at 50k or less.
Assist with the Credit Balance report which prints weekly and is disbursed accordingly.
Manage and comply with all rules and regulations specific to the accounts you are assigned.
Attach all implant invoices and supportive documentation to the claim and submit promptly per contract with each payer.
Retain and maintain all third-party payer remittance and status reports that you are in receipt of.
Consistently identify accurate FSC/Plan for visits, ensure patient’s account is billed accurately by consistently utilizing “AW” function, and strive to be proactive by educating departments as needed on accuracy of FSC/Plan assignment.
Set an example of teamwork and a professional attitude.