Patient Account Rep

Central Florida Health Care•Winter Haven, FL

3d•Onsite

About The Position

The Patient Account Representative is responsible for the prompt and accurate submission and follow-up of all third-party claims, posting insurance payments, adjustments, and denials. This role also involves correctly identifying and updating insurance entry information, managing electronic remittances, sorting mail, uploading EOBs, and reconciling patient accounts. The representative will answer questions related to patient accounts, work closely with center leaders and staff, and insurance companies to resolve claim holds. Additionally, they will follow up on patient balances, ensure accounts are transferred to the appropriate responsible party, maintain trending of claim denial reasons, and submit necessary documentation for claim resubmission. The position requires knowledge of federal laws and regulations affecting coding requirements, Electronic Health Records (EHR), and billing practices, with FQHC experience preferred. Strong math, communication, problem-solving, and computer skills are essential, as is the ability to work independently and handle difficult situations tactfully.

Requirements

Minimum of 1-3 years healthcare experience working in a managed care, revenue cycle or billing office setting
Knowledge of medical terminology or concepts is a must
Proficiency in Microsoft Office applications including Word, Power Point, Excel, and Outlook is a must.
High school graduate or equivalent required.
Knowledge of billing practices and billing office functions required
Knowledge of medical records, E H R required
Must have good math skills and effective communication skills
Must have good problem-solving skills
Communicating clearly and concisely, orally and in writing
Confidentiality
Ability to use the computer
Ability to work independently to accomplish assigned work in a timely manner
Ability to communicate with staff and the public, both in person and over the phone, in a tactful manner and under difficult situations
Understanding and carrying out verbal and written directions
Follow CFHC policies and procedures
Works independently in the absence of supervision

Nice To Haves

FQHC preferred
Occasional travel required

Responsibilities

Responsible for prompt and accurate submission and follow-up of all third-party claims
Post insurance payments, adjustments and denials
Responsible for correctly identifying and updating various types of insurance entry information.
Submit medical and dental claims for prompt payment
Review, research and correct all claims on hold or denied due to insurance eligibility or billing errors
Manage Electronic Remittances, sort mail and upload EOB’s
Sort mail, upload and review EOB’s and reconcile patient accounts
Answer questions related to patient accounts
Work closely with center leaders, center staff and insurance companies to resolve insurance and claim holds.
Follow up on patients with balances due to collect payment
Ensure that accounts are transferred to the appropriate responsible party for reimbursement (insurance, secondary payer or patient)
Maintains trending of claim denials reasons to assist with training and education to staff
Submit additional paper work, documentation necessary to re submit claims for payment
Notify patient of non-sufficient funds
Assist with reports related to trends and accounts receivable for management