Commercial Patient Account Representative

Description

Position Summary:

• Commercial Patient Account Representative, II is responsible for all billing and/or collections of Commercial payor accounts to ensure that PFS is capturing all revenues as timely and efficiently as possible.
• This position takes ownership of their accounts and eliminates barriers to ensure timely and correct payment including involvement with payors upper management, when necessary.
• This position will have working knowledge and understanding of Commercial managed care contracts including other complex payment methodologies to ensure prompt and accurate reimbursement. Complies with State and Federal statutes and regulations.

Essential Duties:

• Adheres to all confidentiality policies and procedures and carries out all tasks in a pleasant and respectful manner.
• Able to be at work and on time, follow organization rules and procedures and directions from a Coordinator/Lead or other member of the Management staff.
• Researches and responds to patient and/or Commercial insurance inquiries timely, effectively and according to policies and procedures resulting in resolution.
• At all times, provides professional and exceptional customer service when interacting with internal and external customers.
• Documents all communications in the financial system and updates demographics ensuring accuracy and appropriate information to move the account towards payment.
• Meets productivity goals as set by Management.
• Reviews and processes Commercial insurance company refunds in the financial system by ensuring the refund amount is appropriate.
• Uses critical thinking skills to monitor and follow-up on Commercial payor claims to ensure correct hospital reimbursement in a timely and accurate manner.
• Demonstrates knowledge of Commercial payor hospital account management billing and collections skills.
• Demonstrates appropriate, aggressive telephone and/or online follow-up as necessary to expedite payment of billed charges with minimal supervision.
• Be at work and be on time.
• Follow company policies, procedures and directives.
• Interact in a positive and constructive manner.
• Prioritize and multitask.
• Other duties as assigned.

Skills:    

• Required Skills & Experience:
• Minimum two (2) years’ experience and understanding of Commercial payor hospital collections processes.
• Excellent interpersonal skills.
• Positive work ethic.
• Written and verbal communication skills to meet productivity standards.
• Microsoft Office and Outlook experience.
• Ability to provide prompt and courteous customer service to all internal and external customers.
• Ability to use critical thinking to research, review and follow-up on all accounts.
• Ability to communicate effectively in verbal and written form.
• Ability to analyze documentation and resolve patient, billing and/or collection issues appropriately and timely.
• Ability to identify problems in a timely manner and initiate appropriate actions to resolve problems or issues.
• Ability to make suggestions for enhancements throughout the department and continually seeks opportunities to improve current policies, procedures and practices.
• Ability to recognize and perform essential duties and offers assistance to others or performs other required tasks when own assignments are completed.
• Ability to use critical thinking while reviewing billing and collection notes in the financial computer system to ensure that the appropriate action is taken within the billing and collection process and to ensure correct hospital reimbursement.

Preferred Skills & Experience:

• Use of 10-key calculator by touch.
• Knowledge of medical terminology and coding.

Education:         

Required Education:

• High school diploma or GED.