SUMMARY

The Patient Accounts Representative is responsible for providing support to the billing department manager. The position’s goal is to maximize cash inflows through billing and collecting for the services the company provides, while maintaining compliance with all applicable laws and regulations. The position will be responsible for all insurance follow-up activities with payors in a courteous and timely manner.

Representatives will process patient accounts to third parties and resolve accounts to a zero balance. Expertise in all third-party billing and contracted payment agreements. The account representative is required to have good writing skills and ensure proper account documentation. Verbal communication required for relaying issues/concerns with problem accounts to supervisor and mangers.

DUTIES AND RESPONSIBILITIES · Verification of financial responsibility to accurately bill the correct party. · Accumulating additional information as necessary to substantiate the medical necessity of the transport. · Data entry into the computer system. · Printing, auditing, and disbursement of paper and electronic bills and claims. · Follow up calls and letters to insurers, individuals, and third-party payers to ensure timely remittance of their obligations. · Coordinating payment plans with patients and their representatives for the non-covered, or self-insured portion of their charges. · Appealing denied claims with additional documentation of medical necessity. · Documentation of process into the patient account computer record. · Maintenance of the patient medical and billing records. · Maintenance of files relating to correspondence. · Responsible for the resubmission of primary, secondary, and tertiary claims per respective regulations and policies. · Reports productivity results daily to the department supervisor. · Works minimum standard number of accounts per payer per day. · Meets or exceeds collection goals by payer each month. · Works all assigned accounts at least once every 15 or 30 days, depending on balance. · Participates in educational activities and attends department staff meetings. · Maintains confidentiality: adheres to all HIPAA guidelines/regulations. · Assistance with incoming calls, subscription program, and the general operations of the business office including on-site customer service for billing activities. · Other duties as deemed necessary.

MINIMUM QUALIFICATIONS

Education and Experience:

High School Education required. Three to Five years’ experience in medical office billing preferred. One-year EMS Billing experience preferred. ICD-10 Coding experience helpful. Experience with Medicare part B, Medicaid, Commercial insurance, and Fair Debt Collection Law helpful. Familiarity with medical terminology helpful. Intermediate knowledge of Microsoft Word and Excel helpful.

Skills and Proficiencies

Effective knowledge of EMS desired. Accurate typing at least 30 wpm. Proficient in oral and written communications, especially telephone. Highly proficient in the use of computers generally. Must be able to learn and understand patient accounting policies and procedures and how the Accounts Receivable computer system works. Must be able to use a computer, calculator, fax machine, copier, printer, scanner, postage meter, and other office tools efficiently to meet performance goals. Dependable in both production and attendance.

Certifications: None required

PHYSICAL REQUIREMENTS Occasionally: Walking outside, lifting, pushing, pulling, reaching, balancing, carrying, kneeling, stooping, bending, leaning, sitting, flexibility, driving car.

Frequently: Touching, typing, climbing, multiple physical activities performed at the same time.

Constantly: Hearing/listening, clear speech, walking inside, seeing.

WORKING CONDITIONS: Constantly: Works alone, with others, around others, face-to-face and verbal contact with others, extended day, inside.

MENTAL REQUIREMENTS Constantly: Simple reading and writing, complex reading and writing, clerical, memorization, analyzing, perception/computation, problem solving, simple math skills, judgement, reasoning, decision making.

EQUIPMENT USED Constantly: Telephone recording equipment, facsimile, computer/typewriter, keyboard, telephone, copy machine, stapler, 3-hole punch, stamping, sharpener.