Patient Accounts Representative organizes inpatient and outpatient claims for electronic or hard copy mail and forwards to appropriate third party payers. Reviews claims to make sure that payer specific billing requirements are met, follows-up on billing, determines and applies appropriate adjustments, answers inquiries, and updates accounts as necessary. Being a Patient Accounts Representative requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Patient Accounts Representative works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Patient Accounts Representative typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)
Carson City, NV | Per Diem US:NV:Carson City Patient Financial Services
About Carson Tahoe Health
CTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by the Center for Improvement in Healthcare Quality (CIHQ). CTH was voted 5th most beautiful hospital in the nation nestled among the foothills of the Sierra Nevada in North Carson City and only a short drive away from world-famous Lake Tahoe & Reno. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.
Summary
The Customer Service Representative serves as the hospital’s primary contact for all patient billing inquiries. Acts as a liaison between Carson Tahoe Regional Healthcare and patients, providers, and payers for all post-care matters related to account resolution. Provides information regarding hospital billing practices, policies, and patient billing statements. Assists patients in understanding billing statements to ensure swift resolution of outstanding balances. Fulfills the organization’s mission of care and service by providing superior customer service to the patient community. Complies with State & Federal regulations with regard to billing & collections.
Responsibilities
• Accepts inbound phone calls from patients, physician offices, insurance carriers, etc. within a specific response-to-call time-frame and with the intent to resolve the caller’s concern immediately.
• Follows scripts as provided by the Customer Service Supervisor to facilitate consistent and expedient account resolution.
• Responds promptly to patient inquiries regarding hospital billing procedures, policies, and statements.
• Collects patient payments and follows levels of authority for posting adjustments, refunds, and contractual allowances.
• Understands different payer regulations and can communicate effectively with patients regarding their Explanation of Benefits (EOB).
• Documents all patient accounts activities concisely, including future steps needed for resolution.
• Prepares written responses to patient and customers regarding account resolution and customer service recovery.
• Interacts effectively with other departments on a daily basis to facilitate patient account resolution.
• Identifies barriers to efficient departmental operations and takes an active role in developing effective solutions.
• Makes outbound phone calls to patients to collect or make arrangements for payment of outstanding balances.
• Processes Charity applications in a timely manner and according to policy.
• Processes incoming mail in a timely manner (24 hours)
• Accurately adds/updates patient demographic and insurance data.
• Performs other related duties as assigned.
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Qualifications
• Required o High school diploma (or equivalent) o 1 year experience in a physician office or hospital setting o 1 year experience with medical billing/collection and healthcare insurance o 1 year experience with Microsoft Office (Outlook, Word, Excel) Preferred o Knowledge of medical terminology, anatomy/physiology o Previous experience in a call center o Bilingual-Spanish o Proficient with standard office equipment and PC software
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