Patient Relations Representative IV

Jackson County•538 Scotts Creek Road -- Sylva, NC

About The Position

The Patient Relations Representative IV is responsible for accounts receivable, billing, and fee collection and is cross-trained to provide reception, appointment scheduling, and medical records support. The role provides clerical and supportive assistance to staff and clients and helps promote and protect the health of Jackson County residents. This position works a 40-hour week, Monday through Friday, with a one-hour lunch break. The two-person accounts receivable team rotates weekly between 7:30 a.m.–4:30 p.m. and 8:30 a.m.–5:30 p.m. to maintain clinic coverage. Schedules may vary slightly based on department needs and supervisor approval. Occasional evening or weekend work may be required; the position is on call for after-hours emergencies and outbreaks and must work nights and weekends when necessary. The representative handles clinic and laboratory billing, patient payments, insurance claims and denials, account adjustments, daily reconciliation, and related accounting records. The position also prepares required patient forms, performs a monthly computerized time study using Microsoft Excel, and complies with HIPAA requirements. The employee may be directed to participate in public health preparedness activities, including working extended hours or long shifts during public health emergencies, and performs other duties as assigned.

Requirements

High school graduation and at least two years of office assistant or secretarial experience, or an equivalent combination of training and experience.
General knowledge of office or work-unit procedures, methods, and practices.
General knowledge of ICD-10 and CPT coding.
Knowledge of correct spelling, punctuation, and specialized vocabulary, with the ability to proofread.
Significant knowledge of accounting procedures, principles, and practices.
General knowledge of office accounting and record-keeping procedures and mathematics, and their application in the work environment.
Ability to learn and independently apply laws and departmental rules and regulations covering programs and services.
Ability to review and process information to determine conclusions, actions, or compliance with applicable laws, rules, or regulations.
Ability to apply work-related formulas and mathematical calculations; record, compile, summarize, and perform basic analysis of data; and balance and reconcile figures.
Ability to use a variety of office equipment and learn to use specialized office equipment.
Ability to interact with people courteously and tactfully in public-contact duties.
Ability to record and compile information based on general guidelines, screen communications using predetermined guidelines, and provide information and instructions about work processes and procedures.
Possess and maintain a valid North Carolina driver's license.
Work nights and weekends when necessitated, including as needed for after-hours emergencies or public health events.

Nice To Haves

Bilingual ability preferred; at a minimum, the ability to understand and make oneself understood to Spanish-speaking individuals.
Ability to coordinate the work of other support staff, student workers, or volunteers may be required.

Responsibilities

Bill clinic services using Superbills, ICD-10 codes, and CPT codes.
Collect fees and check out patients receiving clinic and laboratory services.
Determine eligibility for applicable programs and provide information about medical and financial assistance resources.
Resolve account problems and make adjustments when needed.
Verify, code, and balance clinic services daily; post payments; and complete daily cash reconciliation.
Code insurance payments made by direct deposit and incoming bills for payment.
Bill patient insurance plans for services and work insurance denials.
Manage the monthly Aged Accounts Report and enter patient data for monthly service billing.
Track BCCCP patients seen and coded bills on a fiscal-year spreadsheet.
Contact specified hospitals and radiology providers regarding patient account and billing concerns.
Advise reception, clinic, laboratory, and patients about service costs, including self-pay laboratory prices and lab orders.
Answer patient billing and account questions by phone and otherwise.
Work Batch Status in the EHR daily to ensure billing accuracy and eliminate errors.
Prepare Disclosure of Information, Medicare Waiver, and Pregnancy Consent forms as applicable.
Complete the monthly computerized time study report using Microsoft Excel to allocate salary expense to appropriate funding.
Comply with and attest to HIPAA regulations.
Participate in public health preparedness activities and work during public health emergencies as directed.
Perform other duties assigned by the supervisor, Health Director, or Deputy Health Director.