Patient Account Representative

St Josephs Medical Center•Stockton, CA

3d•$34 - $38

About The Position

The Patient Account Representative manages billing and collections tasks for patient accounts associated with hospital and clinic facilities. The role performs timely, accurate billing and collections from insurance carriers, including Commercial, Managed Care, Government, and Third-Party carriers. It follows up on accounts to ensure accurate processing and payment, timely billing and appeals, and completion of actions needed to resolve open accounts receivable balances, including credit balances. The representative may also communicate with internal departments, insurance payers, patients, and other healthcare providers; participate in training, accounts receivable projects, classes, and meetings related to Patient Financial Services; and perform other duties as assigned. The position performs billing and follow-up functions as directed by department leadership; applies financial and medical terminology and relevant regulatory requirements to claim processing and revenue cycle operations; uses reimbursement tools such as payer contracts, claims workflow systems, and expected reimbursement software; follows hospital and clinic billing policies and procedures; and collects accurate information and verifies documentation needed for timely billing and account resolution. St. Joseph's Medical Center is a member of Dignity Health. It is a not-for-profit, fully accredited regional hospital founded in 1899, with 395 beds, a physician staff of more than 400, and more than 2,400 employees. Located in Stockton, California, it specializes in cardiovascular care, comprehensive cancer services, and women's and children's services, including neonatal intensive care.

Requirements

High school graduate or GED.
At least 1 year of experience with billing, collections, and/or revenue cycle operations in an acute care or ambulatory setting.
Typing speed of 40 words per minute.
Ten-key speed of 8,000 keystrokes per hour.
Knowledge of Government and/or Non-Government billing and collections regulations.
Knowledge of claim submission, claims follow-up, the appeals process, and medical and billing terminology.

Responsibilities

Perform billing and follow-up functions as directed by department leadership.
Manage billing and collections for patient accounts associated with hospital and clinic facilities.
Bill and collect accurately and promptly from insurance carriers, including Commercial, Managed Care, Government, and Third-Party carriers.
Follow up on accounts to ensure accurate processing and payment, timely billing and appeals, and resolution of open accounts receivable balances, including credit balances.
Apply relevant financial and medical terminology in claim processing.
Maintain understanding of state, federal, and third-party regulatory requirements applicable to revenue cycle operations, including health-care reform, state surcharges, and CMS requirements.
Use reimbursement tools, including payer contracts, claims workflow systems, and expected reimbursement software.
Comply with hospital and clinic billing policies and procedures.
Collect accurate information and verify documentation needed for timely billing and resolution of patient accounts.
Communicate with internal departments, insurance payers, patients, and other healthcare providers as needed.
Participate in training, accounts receivable projects, training classes, and meetings related to Patient Financial Services.
Perform other duties as assigned.