Patient Account Representative

  • Pullman Regional Hospital
  • 835 SE Bishop Blvd Pullman Washington 99163 United States
  • Posted: Apr 16, 2019
Full-time Office and Clerical

Job Description

 
TITLE:                                  Patient Account Representative
DEPARTMENT:               Patient Financial Services
FLSA:                                   Non-Exempt 40-Hour Work Week
 
JOB SUMMARY:
The Patient Account Representative is responsible for billing, follow-up, and credit balance review for all patient account balances. 
 
QUALIFICATIONS:
Education/Training:  High School Diploma or equivalent.  Prefer an Associates Degree in Business or related field.
 
Experience:  Medical billing experience helpful.
 
License/Registration:  None required.
 
Population Served:  N/A
 
ESSENTIAL FUNCTIONS:
Planning and Prioritizing
  • Reviews and processes daily correspondence for patient balances.
  • Calls accounts on Aged Trial Balance; all accounts over 90 days are a priority.
  • Calls accounts on Aged Trial Balance; all accounts over $1,000 are a priority.
  • Posts patient and 3rdparty payments.
  • Bills client billings once per month.
  • Verifies and prints daily statements to patients.
  • Verifies daily itemized self-pay claims for accurateness and calls patient/guarantor on all accounts for possible insurance information.
  • Calls all patients with account balances over $500 as a priority and all finals.
  • Reviews every itemization for billing, inconsistencies, missed charges or other billing errors.
  • Makes any claim adjustments in the host system daily.
  • Compiles batch information on reconciliation sheet and balances to bank deposits.
  • Delivers deposit to the bank each day.
  • Information Gathering
  • Reviews credit balances and processes according to departmental policy.
  • Obtains referral and authorization information from physician offices as necessary.
  • Gathers attorney billing information and works with HIM department for billing purposes.
  • Processes, documents and files all creditor claims pertaining to Chapter 7 & 13 bankruptcies.
  • Ensures all documentation is complete in the Pullman Regional Hospital Assistance Program Application.
  • Researches and processes client billing credit and adjustments.
  • Decision-Making
  • Exhausts all other resources to receive reimbursement on a claim prior to turning account balance over to the patient.  This includes calling patient/guarantor to obtain necessary documentation and/or information, and calling physicians offices for any other pertinent information.
  • Negotiates payment plans and suggests methods of payment in order to meet patient’s medical obligations using discretion and independent judgment.
  • Determines patient’s financial status and screens for possible Pullman Regional Hospital Assistance Program.
  • Answers client inquiries regarding any billings.
  • Decides whether to hold account in house or refer to vendor for collections and maintenance.
  • Exhausting all resources on mail returns such as, directory assistance, Meditech, WSU directory, and Search America prior to turning account to bad debt.
  • Communication
  • Communicates appropriately with patients, coworkers, physician offices as well as members of ancillary departments throughout the hospital and any other individuals necessary to perform essential job functions.
  • Answers patient inquiries regarding account information.
  • Maintains records, documentation, and account follow-up status on mainframe computer system and in the client files.
  • Communicates payment options to patients with copay or coinsurance balances in order to receive timely payments.
  • Technical Proficiency
  • Produces and verifies for accurateness all secondary and tertiary billings.
  • Produces accurate adjustments on client accounts
  • Adjusts any account information in order to print an accurate, clean statement for patient/guarantor.
  • Utilizes the insurance website and/or One Health Port services to verify eligibility and check claim status on appropriate financial classes.
  • Oversees collection processes for all bad debt accounts.
  • Reports bad debt payments to agencies along with other pertinent information while making necessary adjustments on agency accounts.
  • Teamwork
  • Assists other patient account representatives with questions regarding cross over claims.
  • Assists Patient Financial Services Director with special projects or assignments as requested.
  • Participates in monthly staff meetings and quarterly joint staff meetings between billing and registration.
  • Quality
  • Balances cash reconciliation sheet with actual batches prior to deposit.
  • Outcomes
  • Participates in committees or task forces as requested or required.
  • Personal Education
  • Attends ongoing educational activities as necessary to acquire and maintain competency in medical billing compliance by attending conferences, seminars, and reading appropriate material.
  • Work Effectiveness
  • Utilizes the reminder systems for efficient follow-up on accounts.
  • Uses the reminder system to inform other patient account representatives of account activity.
  • Processes all NSF checks according to hospital policy.
  • Reliability
  • Demonstrates promptness in reporting to work and compliance with meal and break schedules.
  • Completes requested information in a timely fashion.
  • Takes initiative to do other duties as needed.
  • Education of Others
  • Educates coworkers on status and processes of accounts by payor class.
  • Explains insurance benefits and processes to patients.
  • Educates and assists physician’s offices when necessary and other clients when necessary.
  • Creating a Safe Work Environment
  • Identifies safety concerns and actively seeks to resolve these issues.
  • Stewardship
  • Assumes the willingness to be accountable for the well-being of the larger organization by operating in service, rather than in control, of those around us.
  • Ethical Conduct
  • Consistently communicates and collaborates with colleagues about decisions which involve legal and ethical issues.
  •  
    NON-ESSENTIAL FUNCTIONS:
  • Performs other non-essential functions as requested.
  •  
    PHYSICAL DEMANDS:
    Sitting:  50%.   Standing/Walking:  50%.
    Occasional lifting/carrying of supplies and paper weighing up to 40 pounds.
    Occasional pushing/pulling to move supplies and equipment.
    Occasional climbing of stairs to reach other levels of the building.
    Occasional stooping/kneeling/bending/crouching to file in low cabinets, purge old bills and to print forms.
    Occasional reaching/handling/fingering to complete paperwork, use computers, file, and answer telephones.
    Frequent talking/hearing/seeing to interact with staff and customers to complete assigned tasks.
     
    ENVIRONMENTAL CONDITIONS:
    Location:  Inside.
    Occasional exposure to noise from printers, telephones and fax machines.
    Minimal risk of injury due to proximity of moving parts on computer printer, typewriter, and copier.
    Minimal exposure to fumes and caustic materials from copy machine toner and cleaning supplies.
    Minimal exposure to biohazardous materials.
     
    Revised:  01/2010