Patient Account Representative

Phoebe Putney Health System•Albany, GA

2d•Onsite

About The Position

Processes and monitors billing and follow up of claims submitted for payment to insurance payors, governmental payors and state agencies. This role involves preparing billing and follow-ups on claims in a timely manner, performing accurate and timely billing and account reviews, and coordinating with concurrent review precert nurses and/or admitting staff on precertification requirements. The Patient Account Representative also serves as a liaison between the patient, employer, and carrier in resolving claim issues and processes patient inquiry requests within 24 hours. Strong performance includes mastery of creating and maintaining account notes, scanning correspondence into the ChartMaxx system, and submitting the Medicare Credit Balance Report quarterly. The role requires adherence to hospital and departmental attendance and punctuality guidelines, performing all job responsibilities in alignment with the core values, mission, and vision of the organization, and maintaining current knowledge in present areas of responsibility.

Requirements

High School Diploma or GED (Required)
2 - 3 years a structured business environment (Required)
CPAR certification or must be obtained within two years of employment

Nice To Haves

2 - 3 years hospital, Physician office or insurance environment (Preferred)

Responsibilities

Prepares billing and follow ups on claims in a timely manner.
Performs accurate and timely billing and account reviews ensuring that accurate information has been reviewed before sending to applicable payors or state agencies.
Conducts account review ensuring accurate billing information, enters and revises information as needed prior to claim being submitted.
Prepares adjustment bills, rebills, reprints claims and/or other source documents.
Processes failed claims in biller work file according to carrier specific requirements.
Coordinates with concurrent review precert nurse and/or admitting staff on precertification requirements.
Prepares daily productivity reports.
Serves as liaison between patient, employer, and carrier in resolving claim issues.
Communicates with patient, employer and carrier regarding claim status.
Processes patient inquiry requests within 24 hours.
Assists with Customer Service coverage duties as need arises.
Creates and maintains via account notes, all correspondence, whether written or verbal, including discussion with carriers, patients or guarantors.
Scans correspondence into the ChartMaxx system.
Submits Medicare Credit Balance Report quarterly, necessary to ensure that Phoebe Putney Memorial Hospital remains compliant with CMS rules and regulation.
Attends seminars and education relating to Medicare, Medicaid and Commercial.
Attends and participates in hospital and departmental staff meetings.
Documents and submits required information and data in a timely fashion.
Ensures that documentation is tailored to expected readers / users.
Uses correct terminology.
Conforms to required style and format.
Adheres to the hospital and departmental attendance and punctuality guidelines.
Performs all job responsibilities in alignment with the core values, mission and vision of the organization.
Performs other duties as required and completes all job functions as per departmental policies and procedures.
Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs).
Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs.
For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.
Wears protective clothing and equipment as appropriate.