Patient Account Representative

Scotland Memorial Hospital•Laurinburg, NC

About The Position

The Patient Account Representative works in Patient Financial Services at Scotland Memorial Hospital. The role reviews denied and underpaid claims, investigates discrepancies, communicates with payers and Revenue Cycle departments, and works with management to identify denial trends and reduce accounts receivable. The representative maintains payer records and documents payer interactions, supports continuous quality improvement, completes cross-training within Patient Accounts, and begins HBI Revenue Cycle classes. The role requires compliance with HIPAA when handling patient information and includes other duties as assigned.

Responsibilities

Examine denied and underpaid claims to determine the reasons for discrepancies.
Provide payers with specific reasons for suspected underpayments and analyze payer denial reasons.
Work with management to identify, trend, and address root causes of denials and help identify strategies for reducing accounts receivable.
Maintain knowledge of federal and state regulations, payer requirements, and explanations of benefits to identify and report billing compliance issues and payer discrepancies.
Maintain accurate payer files, including contact names, addresses, phone numbers, websites, and other relevant information, and thoroughly document payer interactions.
Handle communications, including telephone and email, from payers and departments within Revenue Cycle.
Participate in ongoing continuous quality improvement efforts, establish goals with the manager, track progress, and attend huddles.
Make recommendations and communicate trends and issues to management.
Cross-train in other areas within Patient Accounts.
Begin HBI Revenue Cycle classes.
Maintain compliance with HIPAA guidelines when handling patient information.
Perform other duties as assigned.