Patient Account Representative

Ashland, KY
Full Time
Mid Level

Function:

The Patient Account Representative will work as part of the billing team to maximize the efficiency and accuracy of Ramey-Estep/Re-group (RE) billing activities. This position is responsible for managing patient accounts, verifying insurance coverage, eligibility and communicating with patients and clients regarding their financial responsibilities. 

Organizational duties & responsibilities:

  1. The primary responsibility of all staff is to ensure the safety and well-being of all Ramey-Estep/Re-group (RE) clients.
  2. Supports the mission, vision, and values of RE.  Facilitates and adheres to the agency’s code of ethics, policies, and procedures.
  3. Supports all functions that attain and maintain accreditation and compliance with regulatory agencies.
  4. Supports and facilitates positive interaction with clients and staff by exhibiting both in-office and in-public when carrying out job duties: individual maturity, respect for others, a team-centered approach, maintenance of confidential information, and awareness and sensitivity to cultural and other differences in clients and staff.
  5. Exhibits effective communication skills, including proper use of agency communication systems.
  6. Participate in appropriate professional development programs to attain and maintain competency.
  7. Effectively manages financial and physical resources to achieve the mission of RE.
  8. Reports incidents of abuse or potential abuse involving clients to the appropriate authorities and RE.

Essential Duties and Responsibilities:

  1. Assist the billing team in identifying, implementing, and monitoring projects that improve the performance of the Billing Department under the direction of the Revenue Cycle Director.
  2. Determine and assist clients and patients with eligibility and coverage issues.
  3. Assisting clients with sliding fee scale and payment plans with clients and ensure compliance with No Suprises Act.
  4. Ensure compliance with all regulatory and organizational requirements.
  5. Communicate with providers, insurance companies, and internal teams to resolve issues.
  6. Review and send billing statements.
  7. Answer incoming patient calls with a question regarding the billing statement.
  8. Answer incoming calls accepting patient payments.
  9. Posting patient payments from mail and online systems.
  10. Respond to requests for additional information that carriers may need to determine payment.
  11. Maintaining accurate medical billing records.
  12. Documenting patient payments and insurance reimbursements.
  13. Reconcile receipts and make appropriate adjustments to patient accounts.
  14. Process payments and credit balances for facilities assigned.
  15. Post all incoming correspondence.
  16. Pull medical records upon request.
  17. Serve as backup for other billing processes.
  18. Performs other duties as assigned.

Working conditions/environment:

  1. Scheduled workdays are Monday – Friday.
  2. Holidays, weekends, and extra hours may occasionally be required.
  3. Environment is an office setting with extensive computer usage.
  4. Maintains a positive, professional attitude, contributing to a supportive work environment.

minimum job requirements:

Education:

High School Diploma or GED required. 
 Medical Billing/Coding, or a related field is preferred.

Experience:

Previous experience in medical billing/coding and provider enrollment/credentialing is required.
Previous experience preferred:
  • Working in the mental health/SUD setting.
  • Troubleshooting AR denials.
  • Eligibility verification.
  • Preauthorization experience a plus

Specific Skills and

requirements:

Must be at least 21 years of age.
Knowledge of professional fee billing for healthcare services, reimbursement, third-party payer regulation, and medical terminology is preferred. 
Knowledge of Managed Care products such as HMO, PPO, and POS.
Ability to multitask, prioritize work, and meet deadlines.
Must have excellent organizational and time management skills.
Must be able to work independently or as part of a team.
Must be detail-oriented and possess a commitment to accuracy.
Must have excellent written and verbal communication and presentation skills; focused on solving the conflict cooperatively, not blame; keeps emotions under control. 
Technical requirements include proficiency with Microsoft Word, Excel, PowerPoint, and other applications the organization or regulatory agencies use.
Ability to understand and relate to the needs of stakeholders from diverse backgrounds.
Ability to work effectively with staff, physicians, and external customers.
Ability to read, write, and converse in English.
Successful completion of a pre-employment drug screen.
Successful completion of a background screening.
Successful completion of a TB skin test or proof of a negative chest x-ray or other documentation.

Specialized Licenses or training:

Successful completion of Excellent Foundations.
Maintain 20 hours of annual training.
Basic Electronic Medical Record (EMR) system training.

Physical Requirements:

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
While performing the duties of this job, the employee is regularly required to stand, walk, talk, hear, and smell.  The employee frequently is required to sit; use hands to finger, handle, or feel; reach with hands and arms; and stoop, kneel, crouch, and climb stairs.  The employee is occasionally required to climb, balance or run.  The employee must frequently lift and/or move up to 10 pounds or more.  Specific vision abilities required by this job include close vision, distance vision, and peripheral vision. 

Supervisory REquirements:

N/A

 
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