Patient Account Representative

Omega Healthcare Management Services•Boca Raton, FL

3d•Remote

About The Position

Under supervision, the Patient Account Representative will be responsible for effectively communicating with patients to explain medical billing and insurance claims, resolve inquiries, and ensure timely payment collection. This role involves handling inbound and outbound patient calls, explaining billing processes, providing customer service, verifying patient information, and working with insurance companies to resolve claim denials. The representative will also educate patients on financial assistance programs and document all communications accurately.

Requirements

Minimum of 1-2 years prior experience/knowledge of medical billing processes, insurance terminology, and reimbursement practices.
Proficient computer skills and experience with electronic health records (HER) or billing software systems.
High School diploma or equivalent.
Proven experience in a customer service or call center role, preferably within the healthcare industry.
Ability to use de-escalation practices for escalated disputes.
Ability to understand and apply guidelines, policies and procedures.
Must possess the ability to read, write and communicate in English.
Ability to communicate effectively both verbally and in writing.
Data entry skill level- minimum of 40-50 WPM preferred.
Interpersonal skills
Basic computer skills
Motivation
Teamwork
Customer/Patient focused
Professionalism
Organizational skills
Requires knowledge of state and federal healthcare laws and regulations.
Strong attention to detail and accuracy.
Ability to learn and master multiple computer and phone systems quickly.
Requires highly developed communication skills to effectively work with all levels of management throughout the UnityPoint Health, its subsidiaries and affiliates.

Nice To Haves

Additional education in healthcare administration or related field is a plus.
Medical billing experience
Bi-lingual
Prior experience in a third-party collection or medical collections and knowledge of industry terminology, principles and procedures is highly preferred.
Knowledge of DRG’s, Revenue Codes, CPT/HCPC Codes, modifier assignment and government rules/regulations for inpatient and outpatient hospital billing, skilled nursing billing, inpatient rehab and inpatient psych.
2 Years of Epic
1 Year of Denials/Appeals and/or Account Resolution

Responsibilities

Handle inbound and outbound patient calls to address medical billing statements, insurance claims, payment collection, and related financial matters.
Explain billing processes, insurance coverage, and payment options to patients in a clear and concise manner.
Provide outstanding customer service by addressing patient inquiries, resolving billing discrepancies, and answering questions regarding insurance benefits and claim status.
Verify patient demographic and insurance information, ensuring accuracy and making necessary updates as required.
Update patient accounts with relevant information obtained during phone conversations, including payment arrangements, financial assistance applications, or any other relevant documentation.
Work closely with insurance companies, coding specialists, and other team members to resolve any claim denials or issues impacting patient payments.
Assist patients in understanding and navigating the process for filing insurance claims and submitting necessary documentation.
Educate patients on financial assistance programs, payment plans, and available resources for managing medical expenses.
Document all communication with patients accurately and thoroughly in the appropriate systems or databases.
Attend various meetings virtually such as team meetings, training meetings, one-on-one meetings, etc.
Adhere to company policies, procedures, and regulatory guidelines to ensure compliance with patient privacy (HIPAA) and collection practices.
Perform other duties as directed.
Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.