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)
The patient account representative position answers incoming calls from patients and clinics; researches patient concerns and takes appropriate action; updates patient information as needed; works returned mail; verifies insurance and supports the reduction of Accounts Receivables by reviewing open accounts and obtaining payment status via payer websites or by contacting payers by phone. The Representative performs a variety of duties including correspondence response, rebilling, certain denial issues and daily reconciliation of activities. The Representative meets established productivity and quality guidelines to ensure timely and accurate reimbursement for all billed charges. The Representative is responsible for reducing AR aging within assigned payer and assigned section of the AR. This position is responsible for making certain that the hospital receives all monies due in a timely manner.
BASIC KNOWLEDGE AND ABILITIES:
Education / License / Certification
Experience / Skills: