Patient Account Representative

Omega Healthcare Solutions•Denver, CO

1d•$21 - $22•Onsite

About The Position

Under limited 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 initiating outgoing patient calls to discuss medical billing statements, insurance claims, payment collection, and related financial matters. The representative will explain billing processes, insurance coverage, and payment options clearly and concisely, while providing outstanding customer service by addressing patient inquiries, resolving billing discrepancies, and answering questions regarding insurance benefits and claim status. Key tasks include verifying and updating patient demographic and insurance information, documenting communications, and working with insurance companies and other team members to resolve claim denials. The role also involves educating patients on financial assistance programs and payment plans, and ensuring adherence to company policies, procedures, and regulatory guidelines, including HIPAA and collection practices.

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 prioritize and multi-task in a fast-paced, changing environment.
Demonstrate ability to work in all work types and specialties.
Demonstrate ability to self-motivate, set goals, and meet deadlines.
Demonstrate problem-solving skills and the ability to think critically to identify and implement appropriate solutions.
Demonstrate excellent verbal communication skills, with the ability to effectively explain complex billing and insurance concepts to patients.
Strong active listening skills to understand patient concerns and provide appropriate resolutions.
Maintain courteous and professional working relationships with employees at all levels of the organization.
Work in accordance with corporate and organizational security policies and procedures, understand personal role in safeguarding corporate and client assets, and take appropriate action to prevent and report any compromises of security within scope of position.
Ability to remain calm and composed in stressful situations, and effectively de-escalate any conflicts or disputes.
Compassionate and empathetic personality to handle patient inquiries and concerns with sensitivity and professionalism.
Skill in operating a personal computer and utilizing a variety of software applications is essential.
Microsoft Office
ADP
Oracle
E1- Field Employee
Standard Employee
Standard

Nice To Haves

Additional education in healthcare administration or related field is a plus.
Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation is an added advantage.

Responsibilities

Initiate outgoing patient calls to discuss 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.
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.