Patient Account Representative - Patient Financial Services

Montefiore Nyack Hospital•New City, NY

3d•$22 - $23•Onsite

About The Position

Under general supervision and in accordance with established policies and procedures, the Patient Account Representative is responsible for registration, verification, claim submission and follow-up, cash application, account collections, appropriate referrals, and assisting with the selection and/or processing of payment-option assistance through Financial Counseling. The role works with patients, families, insurance companies, healthcare staff, government agencies, and other parties to resolve billing and account matters. The position works assigned trial-balance reports, maintains account-balance integrity, researches explanations of benefits and claim denials, and takes appropriate action to maximize revenue and support timely claim adjudication. It also verifies registration data, updates billing information, addresses inquiries and complaints, documents collection activity, processes account adjustments and refund requests, and completes assigned projects and other duties. The work environment includes business offices, hospital rooms, and the Department of Social Services. The role requires regular light physical effort, including viewing a CRT, frequent standing and walking, bending, stooping or reaching, and occasional lifting of light items up to 20 pounds. Some irregularity in scheduled hours may occur due to compensated overtime requirements, including weekends and/or other shift rotation. The role involves interaction with patients and the public.

Requirements

High school diploma or equivalent required.
Excellent verbal and written communication skills.
Clerical or billing experience preferred.
PC/CRT experience preferred.

Nice To Haves

Clerical or billing experience.
PC/CRT experience.

Responsibilities

Work assigned trial-balance reports, concentrating on high-dollar and aged accounts, and maintain account-balance integrity.
Become familiar with assigned payer contracts and maintain working relationships with insurance-company contacts to support prompt claim adjudication.
Research explanations of benefits (EOBs) and take appropriate action to maximize revenue.
Work with the admitting and verification department to identify and resolve process issues.
Request medical records when needed for insurer requests or appeals, and identify clinical denials for supervisor follow-up or referral to Case Management.
Correct claims as needed to ensure submission of clean claims to payors.
Handle telephone inquiries and complaints through resolution, using appropriate resources to make informed decisions.
Document collection activities and actions accurately and promptly in account notes.
Verify registration data on registered accounts and contact patients when necessary to update billing-system information.
Update insurance and demographic information based on data mailers returned by patients.
Complete requests from outside departments and entities, including insurance carriers, physicians, attorneys, and courts.
Maintain positive job behaviors and telephone etiquette in interactions with the public.
Discuss problems and trends with the immediate supervisor and work toward appropriate resolutions.
Maintain appropriate logs and reconcile necessary details.
Adjust accounts receivable and bad-debt accounts to the proper balance.
Research credit balances and appropriate allowances or refunds, and process refund requests.
Perform special projects and other duties as assigned.
Support the hospital mission and participate in department- or hospital-wide activities that improve processes or outcomes.
Provide positive customer interactions, communicate respectfully across cultures and beliefs, acknowledge concerns, take corrective action, comply with customer-service behaviors, and escort customers when necessary.
Use resources to maintain and improve professional knowledge, comply with licensure or certification requirements, and participate in annual competency assessment.
Use equipment and supplies in a fiscally prudent manner and follow the charge process for supplies and equipment.
Complete projects and assignments within expected time frames.