Patient Account Representative

GENERAL SUMMARY :

The Patient Account Representative is responsible for maintaining patient accounts by assisting Physician staff and the Central Billing Office to resolve issues related to Revenue Cycle. The Patient Account Representative may provide training to the Physician practices to facilitate resolution of patient accounts by training about insurance companies, government agencies and patients in the payment for services that have been provided. The Patient Account Representative will respond to questions, research discrepancies and insurance denials while following Florida Hospital policies and procedures for billing and account management.

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES :

• Work with offices to resolve billing tasks to prepare claims for submission to insurance companies

• Work directly with the Physician practice and/or patient to get a claim processed and paid

• Review and assist Physician office and Central Billing Office with appeals of unpaid and denied claims

• Work tasks related to RTE and claim denials to find resolution and obtain payment

• Verify patients' insurance coverage through eligibility system, contacting patient or calling insurance company

• Assist office with referrals and authorization process

• Assist Central Billing Office with obtaining copies of Medical Records

• Provide training and education to front office staff to include: eligibility, authorizations, tasks, claim edits and denials.

• Provide software training relating to front office duties and skills necessary related to revenue cycle

Qualifications
KNOWLEDGE AND SKILLS REQUIRED :

• Demonstrated effective communication and interpersonal relation skills

• Demonstrated computer experience using word processing and data entry software

• Must be able to type 40 wpm and know 10 key by touch

• Previous insurance billing experience

• Previous collections work experience in a physician office setting

• Strong understanding of bundling issues, modifiers, medical necessity guidelines and physician office billing

• Proficiency in Medical Terminology

• Solid understanding of all Federal and local regulations by payer

• Previous customer service work experience

• Problem Solving Skills and Attention to Detail

EDUCATION AND EXPERIENCE REQUIRED :

High School Diploma or Equivalent

1 years' experience working in health care or completed a certificate or degree from a medical billing program

Experience working with ICD-9, ICD-10 and CPT coding

Insurance and A/R experience specific to eligibility, authorizations and claim denials

EDUCATION AND EXPERIENCE PREFERRED:

Associates Degree; NextGen, Cerner and Athena Software experience preferred

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