GENERAL SUMMARY: The Patient Account Representative is responsible for the billing and collection of accounts from all payers. Continually obtain resolution to billing problems that delay cash and to give feedback to Patient Accounts Supervisor for resolution of future claims. Will perform continual audits to ensure that the AR is billed and collected timely making recommendations to the Patient Accounts Supervisor for resolution to any delays.
1. Reviews and works all accounts from initial billing through follow-up and collection to ensure appropriate reimbursement is obtained, timely billing is done and that all billing deadlines are met.
2. Runs Claim Builder on a schedule as established by the Patient Accounts Supervisor and/or Patient Accounts Manager and ensures that all accounts have been billed.
3. Works all special collection projects identified by the Patient Accounts Supervisor in order to reduce AR and improve cash flow.
4. Identifies any Unicare system billing issues and communicates these clearly to the Patient Accounts Supervisor with recommendations for improvement.
5. Reviews all remittance advises and/or explanation of benefits to insure that denials and/or nonpayments are responded to timely and brings to the Patient Accounts Supervisor’s attention any issues that need to be addressed that are creating the non-payment of claims.
6. Processes all adjustments which have been identified and approved by Patient Accounts Supervisor.
7. Updates demographic and insurance information as needed to ensure accurate and timely billing.
8. Submits monthly report to the Patient Accounts Supervisor showing all follow-up billing on accounts that remain unpaid. identifying billing issues which are creating a delay in reimbursement and makes recommendations for process flow improvement.
9. Interacts with Patient Accounts Supervisor on billing issues surrounding the accounts being worked.
10. Communicates verbally and in writing to payers in order to establish necessary relationships that will result in obtaining appropriate reimbursement for accounts being worked.
11. Assists the Patient Accounts Supervisor as directed by the Manager with process flow improvements which have been identified as a result of analysis of outstanding accounts.
12. Any other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES:
Education: High School Diploma
Work Experience: Minimum of 5 years experience in a Healthcare billing setting; Strong billing and collection experience. Knowledge of third party insurance billing required.
a. Communicate both verbally and in writing clearly and concisely.
b. Manage and/or perform multiple tasks simultaneously.
c. Exemplary customer skills
a. Computer skills – preferably Unicare but at a minimum a Healthcare AR/Billing system
b. Personal Computers – minimally, able to use mouse and move around in Windows.
c. Strong analytical skills as well as organizational skills.