Patient Accounts Representative Job Description

Patient Accounts Representative Job Description

4.7
132 votes for Patient Accounts Representative
Patient accounts representative provides direct supervision to department staff and of the billing and collection of all third party payor claims.

Patient Accounts Representative Duties & Responsibilities

To write an effective patient accounts representative job description, begin by listing detailed duties, responsibilities and expectations. We have included patient accounts representative job description templates that you can modify and use.

Sample responsibilities for this position include:

Other responsibilities include assisting with inquiries from outside parties regarding account status, resolve denials, initiate appeals and make proper notations in the Epic system
Billing / collections
Correspondence sorting
Administrative assistance with various Revenue Cycle processes
Processing and responding to correspondence
Other requests as assigned by level of complexity
Processing and responding to correspondence and other requests as assigned by level of complexity
Writing cash batches
Copying checks
Mailing EOB & CBs to insurance companies

Patient Accounts Representative Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Patient Accounts Representative

List any licenses or certifications required by the position: AAHAM

Education for Patient Accounts Representative

Typically a job would require a certain level of education.

Employers hiring for the patient accounts representative job most commonly would prefer for their future employee to have a relevant degree such as Associate and High School Degree in Healthcare, Associates, Business, Medical Billing, Medical, Health Care, Secondary Education, Education, Accounting, High School Education

Skills for Patient Accounts Representative

Desired skills for patient accounts representative include:

Third party reimbursements
Physician third party billing and collections
Excel
Federal and state regulations
Med Metrix and Healthcare Query
Medical necessity and LCD/NCD edits
Medicare DDE system
Epic system
Medical insurance AR follow-up and collection practices
Medical terminology

Desired experience for patient accounts representative includes:

Performing customer service
Sorting correspondence
Ensuring the accuracy of patient records and compliance with State and Federal Regulations
Verifying patient insurance, collecting deductibles, and arranging payment plans
Assisting patients with questions regarding bills, insurance, and alternative payment plans
Supporting organizational goals by providing quality customer service

Patient Accounts Representative Examples

1

Patient Accounts Representative Job Description

Job Description Example
Our company is hiring for a patient accounts representative. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for patient accounts representative
  • Responsible for contacting insurance companies concerning unpaid medical claims via telephone and website
  • Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients
  • Contacts insurance companies concerning unpaid accounts receivables
  • Investigates and appeals unpaid or partially paid accounts
  • Identifies patients accurately and assigns the patient a unique identification number
  • Secures patient accounts in order to maximize reimbursements in a customer service oriented fashion
  • Maximizes the efficiency and accuracy of the collection process by up- front collection and maintaining bill hold reports
  • Provides documentation in the patient’s charts of general consent, information release, advanced care directives, and other requirements
  • Resolves any unusual denials, low payments, or requests for information, including appeals
  • Drafts letters to the insurance company’s Medical Review Board to expedite payment
Qualifications for patient accounts representative
  • Evaluates if payments were made according to contract
  • Files insurance claims and requests statements
  • May provide guidance and technical work direction to less experienced Patient Account Representatives
  • Follows up on outstanding accounts and makes proper notations in IDX system
  • Contacts insurance companies concerning unpaid medical claims via telephone and website
  • Resolves all denials, low payments, or requests for information, including appeals
2

Patient Accounts Representative Job Description

Job Description Example
Our innovative and growing company is looking for a patient accounts representative. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient accounts representative
  • Sorting, filing and scanning documents
  • Processing of EOB requests
  • Reviewing medical record requests
  • Contacts third party payers and patients to determine the reason for non-payments or delays in payments of medical claims
  • Corrects claims and re-files
  • Researches and appeals insurance denials
  • Confirm patient insurance eligibility and benefits
  • Resolve outstanding receivables
  • Process billing and payments to include Medicaid and Charity Care applications
  • Review correspondence for priority or urgent mail, and process accordingly
Qualifications for patient accounts representative
  • Two or more years of experience working specifically in the healthcare field in patient accounts, insurance verifications, medical collections, medical billing, medical office, hospital, clinic, surgery center, insurance industry, call center or similar role
  • Answers patient phone calls, helps resolve patients questions
  • Work with patient to establish payment arrangements or provide assistance with completing free care application
  • Identifies and corrects any accounts within the scope of his/her abilities
  • Recognizes when issues are outside his/her scope of transfers calls appropriately and efficiently
  • Provides information to patients as appropriate, customer service being most important
3

Patient Accounts Representative Job Description

Job Description Example
Our company is growing rapidly and is looking to fill the role of patient accounts representative. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for patient accounts representative
  • Process correspondence while adhering to the correspondence matrix
  • Ensure the correspondence is coded with the appropriate note code
  • Provide a detailed note pertaining to the type of correspondence received and the action taken
  • Identifies and refers more complex correspondence to the appropriate Rep for further processing
  • Update accounts with any insurance information received
  • Follows hospital policy and departmental procedure by securing specific payment agreement for account balances upon receipt of all third party payments
  • Obtains completed credit application, verification of income and expenses for extended credit terms
  • Receives, reviews and processes incoming mail on a daily basis in accordance to departmental procedures
  • Upon personal patient contact or receipt of patient/guarantor credit application
  • Initiates and answers telephone calls related to patient accounts and provides accurate information and explanation of the Medical Center’s credit policy and financial requirement
Qualifications for patient accounts representative
  • Demonstrate strong verbal communication skills
  • Works with all providers via-email and phone calls providing them with demographic information
  • Works with Supervisor to transfer Allscripts AR to bad debt Collection Agency as needed
  • The employee must have have a clear understanding of the entire appeals process from start to finish and also be able to work effectively with the OB/GYN Billing Operations Supervisor and the OB/GYN Coding representative document in EPIC all activity on the patient invoice
  • Must have min of 2 years experience in medical office billing
  • Must have experience working with appeals, denials, and follow-up
4

Patient Accounts Representative Job Description

Job Description Example
Our company is looking to fill the role of patient accounts representative. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for patient accounts representative
  • Enters into the computer all pertinent data and financial transactions to maintain an up to date record of the patient’s account
  • Adds, updates and revises patient demographic and financial information maintaining current and accurate account information
  • Reviews and processes insurance explanation of benefits statements for accuracy
  • Turns to supervisor for unusual circumstances that may include recoups, adjustments, fee schedules, rejections
  • Responsible for researching, identifying errors, and correcting claims denied by insurance companies
  • Must be able to asses claim to determine when appropriate to make charge adjustments, void a charge, or escalate to the team lead and/or another medical billing team
  • Responsible for following up with insurance companies for no response claims
  • Responsible for working with patient calls escalated from the Customer Service team regarding involving billing code issues
  • Research refund request from payor organizations
  • Responsible for preliminary audit of billing code errors before claim submitted to the Coding team
Qualifications for patient accounts representative
  • A Minimum of 1 year experience in a healthcare preferred
  • Ability to answer high call volumes
  • Ability to manage and resolve customer inquiries
  • Ability to resolve problems by clarifying desired information, researching, locating, and providing correct information
  • Must be able to adapt to a quickly changing work environment
  • Ability to display a positive team player attitude
5

Patient Accounts Representative Job Description

Job Description Example
Our company is growing rapidly and is hiring for a patient accounts representative. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for patient accounts representative
  • Responsible for routing complex claim denial to team lead and/or the appropriate medical billing team
  • Responsible for identifying issues which can be resolved by programing software to prevent denials
  • Responsible for becoming a subject matter expert on the payor policies
  • Responsible for communicating and resolving problems with the provider representatives
  • Responsible for simple level coding, including diagnosis review, modifier applications, some CPT cod changes following process documents and payor policies 
  • Be responsible for answering inbound patient calls in a call center environment
  • Answer patient emails in Electronic Medical Record system
  • Making outbound collection calls to patients to obtain information needed to collect payment
  • Straightforward coding
  • Provide price estimates for patients
Qualifications for patient accounts representative
  • Accountable for meeting productivity standards, call quality, attendance, and adherence to work schedule results
  • Prior experience in a clinical medical office preferred
  • Experience with ClinStar, required
  • Skills in establishing and maintaining effective working relationships with colleagues
  • Requires a bachelor's degree or equivalent in education and experience
  • Experience as an edit and/or claims specialist, or equivalent role providing data analysis and decision support, preferred

Related Job Descriptions

Resume Builder

Create a Resume in Minutes with Professional Resume Templates