Patient Accounts Rep

Brown Medicine•Providence, RI

3d•$19 - $31•Onsite

About The Position

Under the general supervision of the Supervisor, this role interviews, pre-registers/registers, and admits patients. The Patient Accounts Rep is responsible for financially clearing accounts for Admission and other Ambulatory Departments by obtaining demographic, third-party insurance, and related financial information using LifeChart. This role initiates, reviews, and follows up on patient accounts to ensure proper data collection for billing, reviews existing account balances for previous hospital services, and requests cash deposits by approximating charges for scheduled services or co-payments/co-insurance. The role also arranges payment agreements, contacts Patient Financial Advocates when applicable, and makes preliminary determinations on welfare eligibility and/or RIH Financial Assistance programs. Additionally, the Patient Accounts Rep verifies all demographic and insurance information and obtains/applies for necessary referrals and/or authorizations from payers as required by Hospital policies. Brown University Health employees are expected to role model the organization's values of Compassion, Accountability, Respect, and Excellence, and demonstrate the core Success Factors: Instill Trust and Value Differences, Patient and Community Focus, and Collaborate.

Requirements

A level of knowledge generally obtained through completion of High School.
Well-developed interpersonal and communication skills to obtain patient information and communicate effectively with the public via point of contact or phone.
Ability to respectfully set payment arrangement terms and collect payments.
Knowledge of third-party health insurance authorization/validation.
Two year minimum experience in a hospital, physician setting, or health insurance company.

Nice To Haves

Epic ADT/Cadence and/or Billing experience.

Responsibilities

Interviews patients or patient representatives to obtain complete and accurate personal and financial patient information; follows up on missing data by interviewing patients, families, or calling employers, nursing homes, and other facilities.
Utilizes multiple systems to validate the accuracy of patient’s health insurance, acquire authorization, and determine patient’s financial liability.
Contacts patients/families to complete pre-admission demographic and financial information, including patient copays, deductibles, co-insurance, and outstanding balances.
Completes Medicare Secondary Questionnaire, Liability information, etc., when applicable.
Validates patient’s insurance using Passport eligibility system, phone calls to insurance companies, or payer websites.
Obtains authorization for inpatients, observation, and selected outpatients.
Contacts patients and physicians if payers deny authorization approval.
Reviews outpatient/observation pre-admission Medicare patients to ensure the patient class is appropriate following the Medicare status “C” regulation.
Follows up with physicians when applicable.
Validates Advance Beneficiary Notice (ABN) for selected outpatient services for Medicare patients if services are covered.
Works with physicians' offices to ensure accuracy of selected procedures.
Obtains appropriate authorization for patient class changes for in-house patients and visits patients on the nursing unit to explain changes in their financial responsibilities.
Follows up on all missing information and unsigned documents for ED Admissions by visiting patients on the nursing unit.
Meets with patients/families when Medicare patients have used all of their inpatient coverage days to explain options for using Lifetime Reserve Days and makes payment arrangements if they choose not to use them.
Validates if in-house patients with RI Medicaid or Mass Health insurance have a Managed Care product and obtains authorization.
Validates all in-house patients' insurance on the first of each month.
Completes all necessary demographic and financial information for pre-admission testing registration, including information for admission, welcome booklet, and Advance Directives.
Completes Pre-Admission registration.
Completes Direct Admission on the Nursing unit by the Patient Account Representative.
Refers self-pay patients to the Medicaid Specialist/Patient Financial Advocate.
Completes waiver for “Non-Covered Services” for Non-Medicare payers and “No authorization at time of service” for Non-Medicare payers.
Coordinates daily admission reports for payers.
Greets and directs all patients, families, and visitors in a prompt and courteous manner.
Scans identification (license, etc.) upon admission.
Takes patient photo.
Has patient agreement signed.
Explains the Patient Consent and/or Patient Agreement to the patient or designee and obtains all required signatures in accordance with Admission/Registration policies.
Obtains any missing demographic or financial information.
Reviews Passport eligibility response to ensure insurance is valid.
Provides and reviews with the patient or designee the HIPAA Privacy notice, Ethics brochures, Patient Rights, Hospital Directory, Advance Directives, and the Rhode Island Hospital Welcome Brochure and other related information.
Prepares patient ID bracelet and places it on the patient.
Explains waiver for Non-Covered Services and No Authorization at time of service when applicable.
Documents all information into LifeChart and follows the Over the Counter Policy by logging payments and providing receipts per department policy.
Utilizes the LifeChart system and Business Office reports to complete daily work.
Communicates with service departments to obtain MD order information as required.
Utilizes department equipment and systems including LifeChart, Account Maintenance, Hospital Balance Query, My Virtual Merchant, Payer Web Sites, Passport, Workbrain, Flight Tracker, Work Ques, Faxes, Netlearning, SafetyNet, and Valuables Log.
Completes other duties as required.
Attends and participates in staff meetings.
Protects and preserves patient’s right to privacy and confidentiality.
Performs other duties as assigned.