Patient Account Representative 4 – Hospital
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Job Description
Patient Account Representative managing hospital billing, collections, and reimbursement for a health system. Resolving complex patient and insurer accounts while supporting revenue-cycle process improvements.
Responsibilities:
- Perform billing, collections, payment processing and customer service tasks in the Business Office
- Review and update patient accounts in the EPIC system
- Coordinate with patients, coworkers, external agencies, managed care companies, Payor Relations and vendors
- Resolve account, payment, reimbursement, contract and credit-balance issues
- Evaluate root causes, identify trends and escalate issues for process improvement
- Maintain expertise in regulations, processes and policies through training and daily application
- Meet production and quality requirements for accounts receivable, claim counts and past-due accounts
- Respond to customer, coworker and management requests promptly and professionally
- Participate in internal and external meetings as a department representative
- Serve as a subject matter expert and provide training or shadowing support to new team members
- Identify system and process improvements and update workflows
- Lead special projects and updates
Requirements:
- 8 years experience in Revenue Cycle / Hospital Business Office programs (Customer Service, Billing, Follow-up) or equivalent industry experience
- Related certification program in areas such as billing, medical office, coding and accounting can be substituted for 1 year of experience
- Bachelor's Degree can substitute for 4 years of experience; Associate's Degree can substitute for 2 years of experience
- High School diploma or equivalent
- Knowledge of ICD-9/10, CPT and HCPCS coding
- Critical thinking and problem-solving skills for resolving accounts
- Understanding of explanations of benefits from managed care companies and applicable regulations
- Ability to demonstrate teamwork and cooperation and comply with FMOLHS policies, procedures and core values
- Communication, interpersonal and collaboration skills
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