Patient Account Representative II

Patient Account Representative II Lakin Avenue Facility

The Patient Accounting Representative II is responsible for functions within assigned Patient Financial Services (PFS) department. Responsible for accurate and timely action on accounts as it relates to specific responsibilities. Complies with governmental and managed care rules and regulations. Meet department goals as well as productivity and quality standards. Attends and actively participates in training and education.

Responsibilities and Essential Job Functions :

• Reviews research related charges, directing charges to the proper responsible financial payer source.
• Applies billing rules to research related charges billable to third-party health insurance payers based on CMS Claims Processing guidelines for Research Services.
• Invoices study billable services to the correct study and applying the standard applicable discount.
• Assists Study teams and the CTO in understanding of monthly invoices, answering questions and making corrections of any identified errors.
• Follows up with Study Groups on outstanding study related billing and balances owed by the study.
• Assists with traditional follow up for claims handled in the normal insurance billing / follow-up processes for standard of care services billed and followed up by the teams that follow up with insurance when questions arise regarding any impacts of billing related to the patient being in a clinical trial where traditional follow up is unable to remedy the denial.
• Receives and resolves patient billing questions and complaints in a compassionate, courteous, professional and timely manner.
• Takes actions to resolve issues such as changing insurance, re-filing claims, calling insurance companies or answering questions.
• Documents actions taken as directed by department policy.
• Works closely with collection agencies to assure that they receive updated information on accounts.
• Provides input and assists with implementing departmental planning and process improvements.
• Demonstrates the ability to effectively communicate with patients and insurance companies regarding sensitive financial matters.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience :

Preferred Education and Experience :

We are an equal employment opportunity employer without regard to a person's race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.