PATIENT ACCOUNTS REP

Job Description

Responsibilities

The Patient Accounts Representative is responsible for ensuring the accurate processing of all accounts receivable functions.

This includes billing and collections for patients’ accounts and working with third-party payors.

Qualifications :

Education Years of Related Experience

Minimum Preferred Minimum Preferred

High School Graduate / Equivalent X 0 1

Professional Certification 2 3 X

Required Knowledge, Skills, Licensure, Training & Travel Requirements (if applicable) :

A minimum of a high school graduate or equivalent with two years billing / collection experience preferably in a hospital setting.

Is knowledge about billing third-party payors including Medicare and Medicaid plans.

Ability to read, analyze and process assigned patients’ charges and probably bill them to the appropriate third party payor.

Able to do data entry and complete multi-tasks and multi deadlines. Able to communicate effectively orally and in writing with patients, their representatives and / or third-party representatives.

Ability to add, subtract, multiply, and divide in all units of measures, using whole numbers, common fractions, and decimals.

Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Ability to deal with non-verbal symbolism (formulas, scientific equations, graphs, musical notes, etc.

in its most difficult phase. Ability to deal with a variety of abstract and concrete variables.

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel;

reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk; climb or balance and stoop, kneel, crouch or crawl.

The employee must regularly lift and / or move up to 10 pounds and occasionally lift and / or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus.

Qualifications

Verifies Medicare benefits.

Receives all pertinent information on Medicare patients from the Evaluation and Referral Department.

Checks the Medicare Common Working File for current benefits available. Notifies the admission representative of the benefits.

Prints a copy for the financial file.

Notifies the Business Office Manager when a patient has limited benefits.

Completes the UB92 claims forms to submit to Third Party payors.

Ensures all locators on the UB92 are complete and accurate.

Ensures that all necessary documents that need to accompany a claim form are available.

Transmits claims electronically and / or hard copy, whichever is applicable.

Documents the patient’s financial file with the date and amount billed.

Provides a weekly report of all Medicaid claims sent.

Processes the Medicare Remittance Advice.

Upon receipt of the remittance advice promptly completes billing to all secondary carriers when indicated.

Files copy of R / A in all patients folders.

Documents the patient folders with Medicare payment activity.

Documents the patient folders with Medicare payment activity.

Reviews Medicare accounts weekly to ensure claims are being processed and pain in a timely manner.

Reviews the MMR system to detect any unpaid Medicare claims.

Contacts Medicare to resolve problems on all accounts over 14 days old.

Documents all follow-up information in the patient file.

Maintains close communication with MMR.

Ensures all changes, updates and revisions are loaded into our system timely and accurately.

Ensures any errors and / or system problems are resolved timely.

Collects patient folders from Evaluation and Referral and bills and reports from Data Processing.

Provides financial counseling for patients after discharging from the hospital.

Prepares deposits and maintains the cash receipt journals.

Completes insurance and private pay follow-up when necessary.

Obtains MAP552s from Medicaid.

Completes all necessary paperwork for admission of a patient to the hospital and registration of outpatients.

Performs other duties as assigned.

Completes a weekly check of the Medicare payment, prints out and forwards copies to the Business Office Manager and Controller.

Reviews all potential problem accounts with the Business Office Manager and makes recommendations for action when appropriate.

Validates claims in the SSI electronic billing system.

Performs other duties as assigned / required by this position.

Bloodborne Pathogens exposure : (Provide examples if applicable)