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• Patient Accounts Representative 1 processes billing for hospital and clinic patient charges and is responsible for the collection and resolution of accounts.

Job Responsibilities:

• Billing. Completes complex and variable billing claims for medical insurers, auto insurers, SAIF/Workers' Compensation insurers, managed-care contracts, special grants, government agencies; ensures that all billing information is complete and accurate; ensures that billing claims are coded in correctly.
• Third-Party Follow-up and Collection. Reviews billing to determine medical records necessary to provide complete processing of claim; telephones and/or prepares correspondence to third party (insurance carrier, various government programs, etc.); provides explanation of charges; provides additional requested information over telephone or through written correspondence; analyzes accounts for coordination of benefits, refunds, and rejected billings.
• Patient Counseling and Collection.
• Analyzes delinquent accounts with regard to billing and payment history and determines appropriate follow-up action based on departmental guidelines; traces and locates debtor by telephoning and/or sending written correspondence; explains to debtor financial procedures and policies concerning patient balances; arranges appropriate payment plan within prescribed guidelines; requests and reviews documentation of financial information regarding ability to pay and eligibility for financial allowances; files claims to estates of deceased patients; determines which accounts should be referred to external collection agencies; prepares accounts for transmittal to collection agencies when internal collection efforts are determined to be inadequate; provides information to outside agencies involved in collection action or legal action against debtor.
• Adjustment and Legal Document Preparation. Analyzes accounts and processes adjustments for charge errors, contract, and financial allowances; prepares legal documents such as liens, release of liens, estate filings, bankruptcies; complies with special billing requirements regarding adoptions, court holds, Motor Vehicle Accident Fund, promissory notes, and other unique or sensitive accounts.

Minimum qualifications:

• Two years of recent (within the last 5 years) experience billing or collecting healthcare accounts in a business office; OR Four years of general collection, billing or customer service experience; OR Equivalent combination of education and experience.
• Certified Revenue Cycle Specialist (CRCS) is required within 18 months of hire.
• Positions outside of Patient Business Services may not require certification