Patient Account Representative
About The Position
The Patient Account Rep I posts incoming payments to the correct patient accounts, inputs and retrieves data from computer systems, reconciles accounts daily, and applies payments accurately and efficiently. The role distributes billing to appropriate personnel; reviews and follows up on authorizations and specialty referrals; maintains current knowledge of contracts and state Workers’ Compensation fee schedules; and handles hospital-related incoming and outgoing mail, promptly identifying and correcting mailing errors. The representative uses tact and discretion when responding to patient and family inquiries. The role conducts timely and accurate payment analysis of managed care contracts to determine whether appropriate reimbursement has been received. It analyzes insurance payments using complex regulations, guidelines, and systems to support maximum and correct reimbursement of hospital receivables. The representative works with payers and internal resources to identify and resolve barriers to correct account payment, applies relevant California and federal regulations, posts payments, applies contractual adjustments to patient accounts receivable balances as needed, and forwards underpayments and denials to appropriate departments for follow-up and further revenue collection.
Requirements
- Ability to multitask and prioritize needs to meet required timelines.
- Analytical, mathematical, and problem-solving skills.
- Customer service experience.
- Effective written and verbal communication skills.
- High school graduate or GED equivalent.
- Knowledge and basic understanding of medical coding and third-party operating procedures and practices.
- Knowledge of multiple insurance billing requirements and 6 months to 1 year of billing experience.
- Medical and insurance terminology knowledge.
Nice To Haves
- Experience in accounts payable, accounts receivable, or cashier work.
- Familiarity with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology.
Responsibilities
- Post incoming payments to the correct patient accounts daily.
- Input and retrieve data from computer systems and reconcile accounts daily.
- Apply payments accurately and efficiently, and apply contractual adjustments to patient accounts receivable balances as needed.
- Distribute billing to appropriate personnel.
- Review and follow up on authorizations and specialty referrals.
- Maintain current knowledge of contracts and state Workers’ Compensation fee schedules.
- Handle hospital-related incoming and outgoing mail and promptly recognize and correct mailing errors.
- Use tact and discretion when handling inquiries from patients and their families.
- Analyze managed care contract payments and insurance reimbursements for accuracy and appropriate payment.
- Work with payers and internal resources to identify and resolve issues that hinder correct account payment.
- Apply California and federal regulations to payment practices to support compliance.
- Forward underpayments and denials to appropriate departments for follow-up and further revenue collection.
Benefits
- Paid time off
- 401K retirement plan
- Medical coverage
- Dental coverage
- Vision coverage
- Tuition reimbursement
- Voluntary benefit options
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
