Patient Account Representative

Scotland Health Care System in Laurinburg, North Carolina•Laurinburg, NC

About The Position

The Patient Account Representative works in Patient Financial Services at Scotland Memorial Hospital, reviewing denied and underpaid claims, investigating discrepancies, and communicating with payers and Revenue Cycle departments. The role helps identify denial trends and root causes, supports strategies to reduce accounts receivable, maintains payer information and interaction records, and contributes to continuous quality improvement. The representative also cross-trains in other Patient Accounts areas, begins HBI Revenue Cycle classes, and follows HIPAA requirements when handling patient information.

Responsibilities

Examine denied and underpaid claims to determine the reasons for discrepancies.
Provide payers with specific reasons for suspected underpayments and analyze payer denial explanations.
Work with management to identify, trend, and address root causes of denials and help pinpoint 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 details and other pertinent information, and thoroughly document payer interactions.
Handle communications from payers and departments within Revenue Cycle by telephone and email.
Participate in ongoing quality improvement, establish goals with the manager, track progress, and attend huddles.
Show initiative and resourcefulness by making recommendations and communicating 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.