DESCRIPTION OF POSITION:

The Patient Account Representative will handle inbound and outbound calls from patients and insurance companies, and provide accurate and professional information about their accounts, benefits, and payments. This position will also update patient records, verify insurance eligibility and authorizations, and follow up on outstanding balances, while complying with HIPAA guidelines and maintaining confidentiality. This position will also understand different patient account processes, and complete assigned tasks in a timely manner.

RESPONSIBILITIES AND DUTIES:

• Manage all inbound and outbound customer calls in a timely manner
• Accurately evaluates each account in order to determine what is needed, what is left outstanding and what steps are necessary to resolve the account in both patient Practice Management System
• Answers phones with correct salutation and professionalism
• Strong phone and verbal communication skills along with active listening
• De-escalate situations involving dissatisfied customers, offering patient assistance and support
• Explains insurance benefits and patient responsibilities
• Follows appropriate payment guidelines. Approaching patients for Payment in full, Payment Plans and Future Payment information as appropriate per the call
• Obtain financial information from patients/guarantors to determine free care eligibility
• Verify insurance, eligibility, and obtained authorizations when required
• Manage insurance changes and requirements
• Ensure current carrier information is maintained in Patient Account System
• Monitor accurateness, suitability and totality of patient accounts
• Followed up on accounts with outstanding balances in appropriate manner
• Document all calls, correspondence, and related activities to each patient's account
• Remained compliant with HIPAA guidelines and maintains the strictest confidential practice when dealing with patients' personal and financial information
• Demonstrated capacity to work under pressure and ability to multitask at all times on many different levels
• Maintains assigned task by ensuring that the task is completed timely
• Research returned mail; update patient demographics accordingly
• Understands Statement paths, next follow up dates and updates appropriately to maximize collection potential
• Understands UCC, MVA, Bankruptcy, Deceased and all Patient Account patient processes in order to properly offer assistance to patients
• Performs other duties as assigned to meet the organization's needs
• Supports organizational changes. Demonstrates flexibility in providing coverage and/or availability for the call center for unexpected absences, events, or call volume variance
• Identifies and resolves patient billing complaints
• Performs various collection actions including contacting patients by phone.
• Answer patient and/or insurance phone inquiries; utilize claims software to check status of claim, submission history and eligibility.
• Ability to multi-task, set priorities and manage time effectively.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

• High school graduate or GED certificate.
• At least one year experience in Healthcare or related field preferred.
• Adequate keyboarding skills (40 words per minute typing rate); Basic computer skills.
• Ability to communicate with patient, family, peers, and medical personnel.
• Strong organizational and communication skills, including ability to discuss medical issues.
• Negotiation skills including assertiveness and being proactive.

 Physical Demands/Work Environment

• Work requires a variety of physical activities, including moving about within and outside of all hospital properties for long periods of time. 
• Must be able to respond quickly and effectively to emergency and non-emergent situations.
•  May be required to assist in controlling disorderly conduct or combative patients.
• Must be able to exchange accurate information with patient, family, peers and medical personnel.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.