Patient Accounts Representative

William Newton Hospital•Winfield, KS

About The Position

Responsible for the insurance billing process between the hospital and insurance companies, federal agencies, and third-party payers. Audits patient accounts to help ensure accuracy of procedures, charges, and coding; collects payments; and participates in performance improvement and continuous quality improvement activities. This is a full-time, hourly, weekday position. The role coordinates claims and payments, follows up on account issues, resolves overpayments, supports payment and receipt processing, posts adjustments, and maintains accurate patient account records. It also involves communicating with patients and families, insurance companies, government agencies, hospital departments, and Business Office staff while protecting patient confidentiality. The representative assists customers at the business office counter and performs cash-handling, deposit, and equipment-safety duties. The position requires adherence to hospital policies and professional standards, completion of required education and in-services, timely attendance and work completion, and participation in appropriate committee, CQI, and management meetings. The employee is expected to support the hospital’s mission, vision, and core values and comply with safety, emergency preparedness, infection control, and ethical business practice requirements.

Requirements

High school graduate or equivalent.
Maintain patient confidentiality at all times.
Adhere to the dress code and wear identification while on duty.
Report to work on time and as scheduled, complete work within designated time frames, and use the computerized time system correctly.
Use internet-based insurance resources for education, eligibility, follow-up, and billing as applicable.
Comply with organizational policies and procedures, including ethical business practices, safety, fire, infection control, emergency preparedness, and William Newton Hospital policies.
Demonstrate familiarity with the employee handbook and knowledge of, or ability to locate, the Safety/Emergency Preparedness Manual and disaster packets, personal protective equipment, and responsibilities during emergency codes.
Demonstrate flexibility, organization, and the ability to function in stressful situations; communicate clearly and accurately with the Business Office Director and staff.

Nice To Haves

Thorough understanding of different insurance plans and government agencies, including Medicare and Medicaid, as they relate to assigned insurance responsibilities.
Previous billing experience.

Responsibilities

Coordinate the payment process and submit claims to appropriate insurance companies, government agencies, and third-party payers using the billing system.
Maintain professional working relationships with insurance companies, government agencies, third-party payers, patients, families, and hospital departments.
Independently resolve account problems and conduct timely follow-up on unpaid claims.
Resolve overpayments and communicate with the Business Office Director regarding refunds.
Assist with receipt processing and adjust patient bills to reflect credits, debits, and balances.
Understand pre-certification and referral processes for assigned insurance plans.
Document correspondence and conversations with insurers, government agencies, third-party payers, and patients in patient accounts.
Stay informed about changes in the insurance industry and consult hospital departments to obtain or verify billing information.
Perform limited account audits to verify charge and coding accuracy.
Explain statements and insurance procedures to patients and families, treating them respectfully and protecting confidential information.
Use voicemail as needed to maintain customer communication while away from the office.
Prepare the daily deposit and maintain the correct cash-drawer balance.
Process payment transactions, download and balance electronic remittance advices, and provide customer receipts.
Prepare and post adjustments, contractuals, and rejections.
Enter transactions and patient-account documentation accurately and promptly in the computer system.
Secure large bills and amounts of cash in the safe and place the cash drawer in the safe at closing.
Provide petty cash to hospital departments, collect their daily revenues, and issue receipts for transactions.
Provide change to patients, visitors, and employees; receipt payments received in the Admitting Department or directly from patients or families.
Assist customers at the business office counter.
Operate equipment safely and correctly.
Complete required annual education, hospital and department in-services, and other assigned work.
Attend committee, CQI, and management meetings as appropriate.
Follow hospital policies and procedures concerning department operations, fire safety, infection control, emergency preparedness, ethical business practices, and compliance.
Represent the organization positively and professionally and maintain cooperative working relationships with physicians, departments, and staff.
Perform other assignments as needed.