Patient Accounts Representative Resume Samples

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DR
D Reichel
Dakota
Reichel
4912 Esmeralda Brooks
Dallas
TX
+1 (555) 329 5904
4912 Esmeralda Brooks
Dallas
TX
Phone
p +1 (555) 329 5904
Experience Experience
Phoenix, AZ
Patient Accounts Representative
Phoenix, AZ
Predovic and Sons
Phoenix, AZ
Patient Accounts Representative
  • Reports trends or information pertinent to insurance claims, provider or systems issues to the Supervisor/Manager
  • Researches and processes basic insurance denials and appeals with minimal assistance
  • Assists with orienting, training and mentoring team members
  • Notify manager with patient account and insurance issues
  • Following up with collection and processing in compliance with network policy
  • Perform financial analysis as assigned
  • Evaluates accounts and prepares adjustments to refund payments and correct discrepancies as necessary
Philadelphia, PA
Bwpo Patient Accounts Representative
Philadelphia, PA
Jenkins-Lebsack
Philadelphia, PA
Bwpo Patient Accounts Representative
  • This position will review, correct, and complete edits to claims as assigned
  • Due to the nature of Radiation Oncology billing an emphasis will be placed on referrals and authorizations management
  • The representative will perform other duties that may be assigned
  • This position will review, correct, and complete edit lists as assigned
  • This position will review, correct, and complete weekly edit lists for both Orthopedics & Psychiatry as assigned
  • Follow-up on pending claims. The employee is expected to call the insurance company, document there findings and gather and send the necessary documentation to process the claims
  • The work area is expected to be neat and clean at all times
present
Los Angeles, CA
Patient Accounts Representative, Senior
Los Angeles, CA
Heaney LLC
present
Los Angeles, CA
Patient Accounts Representative, Senior
present
  • Maintain an up-to-date knowledge of trends and regulations to ensure compliance with established regulatory and Hospital guidelines
  • Review and verify the receipt of third party claims; identify errors and seek resolution
  • Contact patients and third party payers to resolve past due accounts
  • Process complex medical billing and collection claims
  • May train newer and/or lower-level Patient Account Representatives
  • Work under the direction of the Patient Accounts Manager to achieve department goals
  • Works assigned Paperless Collection System (PCS) workfile by initiating follow up activity on accounts with third party payers
Education Education
Bachelor’s Degree in Creativity
Bachelor’s Degree in Creativity
Ashford University
Bachelor’s Degree in Creativity
Skills Skills
  • Knowledge of Fair Debt Collection Practices Act (FDCPA) and Health Insurance Portability & Accountability Act (HIPAA) regulations
  • Basic knowledge of medical terminology and/or related healthcare management courses to enable interpretation of clinical documentation and appropriate coding
  • Ability to create basic excel spreadsheets
  • Excellent analytical and auditing skills, and basic mathematics, for reconciliation of accounts
  • Dependable and reliable
  • Ability to multi-task, manage details and organize efficiently and effectively
  • Strong attention to detail
  • Basic Microsoft Excel and Word knowledge
  • Excellent analytical /auditing skills and basic math for reconciliation of accounts
  • Ability to use EMR, other relevant computer hardware and software, telephone, copier, fax machine and other standard medical office equipment
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7 Patient Accounts Representative resume templates

1

Patient Accounts Representative Resume Examples & Samples

  • 1-2 years of experience in a collections or healthcare business office environment
  • Excellent verbal communication and negotiation skills
  • Excellent computer and multi-tasking skills
  • Ability to identify an issue, examine options, and provide an effective solution
  • Working knowledge of Microsoft Excel
2

Patient Accounts Representative Resume Examples & Samples

  • Required:High School diploma or equivalent
  • Required: One year of directly related experience
  • Preferred: Experience in the following areas, Infusion, Transplant, or International follow-up
  • Preferred: Additional training beyond high school
  • Preferred: Knowledge of Epic system
3

Patient Accounts Representative Resume Examples & Samples

  • Required: High School graduate/GED
  • Required: Three years of directly relevant experience
  • Preferred: Patient Account or Coding certification
4

Bwpo Patient Accounts Representative Resume Examples & Samples

  • The representative is responsible for follow-up on all denied claims. He/she is expected to call the insurance company, document findings, and gather and send the necessary documentation to process the claims in a timely manner. He/she is required to have a clear understanding of the entire appeals process
  • Due to the nature of Radiation Oncology billing an emphasis will be placed on referrals and authorizations management
  • The representative must demonstrate initiative, independence, a willingness to learn new tasks, and must be able to work with minimal direction
5

Bwpo Patient Accounts Representative Resume Examples & Samples

  • This position will review, correct, and complete edit lists as assigned
  • The representative is responsible for handling patient and insurance company interactions in a professional manner. He/she must demonstrate excellent customer service skills, including active listening and problem solving
  • Minimum of one year experience in a healthcare environment
6

Bwpo Patient Accounts Representative Resume Examples & Samples

  • The representative is responsible for daily management of accounts receivable process and follow-up in the billing system (EPIC & IDX), including daily screening and correcting of claims for accuracy
  • This position will review, correct, and complete weekly edit lists for both Orthopedics & Psychiatry as assigned
  • Knowledge of Physician third-party billing and collections
  • Knowledge of medical billing programs - EPIC & IDX preferred
  • Knowledge of Orthopedics, Orthopedic Surgery, Podiatry and Psychiatry billing preferred
  • Must possess excellent organizational skills and have the ability to exercise sound judgment in decision making
  • Must know and understand the appeal process for inappropriately denied or paid services
7

Patient Accounts Representative Resume Examples & Samples

  • Responsible for daily management of accounts receivable process and follow­up. Daily management of accounts worked in the PCS system. The appraiser will evaluate progress of work, accuracy, and quality is used to help set benchmarks. Evaluation of work includes quantity of accounts worked daily, accuracy of detail and documentation of work done. This includes daily screening and correcting of claims for accuracy
  • Follow-up on pending claims. The employee is expected to call the insurance company, document the findings and gather and send the necessary documentation to process the claims
  • Appeals. Once a claim is denied and an appeal is appropriate, appeals are to be done on a timely basis in order to avoid the tiling limit. It is expected of the employee to have the knowledge of what can be appealed and what cannot. This includes gathering the information necessary to process the appeal accurately. Such as finding the correct diagnoses or procedure code, pulling of documentation such as fee tickets, EOB's, and requesting medical records. The employee needs to have a clear understanding of the entire appeals process from start to finish and also be able to work effectively with the Liaison, and to document all activity on the patient invoice
  • Customer Service calls. Each employee is responsible for handling customer service calls. Employees must demonstrate excellent customer service skills,
  • Each employee must possess excellent organizational skills. When asked questions by management, each employee is expected to have the knowledge and detail or know how to obtain it
  • Each employee must demonstrate initiative, independence, and a willingness to learn new tasks. They must be able to work with minimal directions
8

Patient Accounts Representative Resume Examples & Samples

  • Check voicemail each morning for overnight calls within 24 hours
  • Respond to inquiries from patients by phone, letter, or in person regarding their accounts. These can include questions regarding accuracy of charges, insurance questions, concerns, denials, and credits. Research patient issues and develop payment plans and other options as needed
  • Contact responsible party/guarantor to expedite collection efforts
  • Discuss patient options and negotiate a payment plan that meets CSHP guidelines
  • Generate credit files for each identifiable delinquent account which may involve: individual counseling, making telephone calls and sending collection letters if appropriate; evaluating patient financial status; setting up appropriate budget payment plans; and providing thorough documentation of action taken and responses made
  • Work all accounts in assigned Paperless Collection System queue on a monthly basis. Document action taken, print out statements and/or transfer account activity to ledger sheets as necessary
  • Screen, counsel and educate appropriate patients regarding CSHP's credit policies/procedures and rebilling fees
  • Document and follow up appropriately on corrective actions as identified by the patient, CSHP providers and/or support staff
  • Handle all returned mail and correspondence appropriately and in a timely manner to include letters from patients, bankruptcy, assignments, and requests from attorneys for billing records
  • Review accounts for possible assignment to a collection agency. Make recommendations to the Business Office Manager, and prepare information for collection assignment
  • Work directly with collection agencies on accuracy of accounts assigned, payment discrepancies, disputed balances, etc., assisting with research as necessary. May also include completing affidavits and assignments for the collection agency in a timely manner, preparing information for the agency when court appearances are scheduled, and going to court on behalf of CSHP when the agency/courts determines that is necessary
  • Review "Red Dot" accounts (problem and collection accounts) and Termination of Care's (TOC's) inquiries and determine action to be taken on each account. Speak with patients at office with account or information problems
  • Work new OB list for previous week's appointments. Call on benefits and send out patient information letter. Track all OB patients to ensure insurance information is current and set up payment options to collect deductibles, co-insurance, etc., due prior to delivery. Track all self-pay OB patients to ensure that balance due is paid prior to delivery
  • Generate TOC requests to the appropriate provider as indicated
  • Work thoroughly all assigned accounts in the Paperless Collection System queue, which averages approximately 1200 patients on a monthly basis
  • In assigned queue, investigate each account for correct insurance information, and make calls to hospital, provider office, Medicaid, or patient to locate and file as needed
  • In assigned queue, check insurance denials for valid reasons
  • In assigned queue, contact patients by telephone or mail to gather necessary information regarding payment/s. Make telephone calls prior to sending final notice and transferring to hold queue. Work hold queue prior to transferring to Collections
  • Work monthly reports outside of queue to include bad addresses, budget plans, dunning lists, surgery schedules, and red dot reports
  • Maintain understanding of and appreciation for confidentiality
  • Attend assigned monthly meetings and functions as specified by the Business Office Manager
  • Attend and complete all required training and development to include annual compliance training
  • At least 3 years related experience in insurance follow up
  • A minimum typing speed of 50 wpm
  • Intermediate computer proficiency in Microsoft Office in Word and Excel
  • Ability to listen to patient concerns and complaints objectively and deal with them tactfully
  • Ability to establish and maintain effective working relationships with staff, patients and the public
  • Must have tact, good public relations skills, maturity of judgment, and a professional attitude and appearance
  • Knowledge of federal, state and local legal and regulatory provisions that relate to collection activities
9

Bwpo Patient Accounts Representative Resume Examples & Samples

  • Review, correction and completion of edit lists weekly for the particular insurance (s) assigned. This requires the employee to be diligent and take the initiative to ensure the entire patient account is corrected, not just the invoice (s) on the list to be corrected
  • Appeals. Once a claim is denied and an appeal is appropriate, appeals are to be done on a timely basis in order to avoid the filing limit. It is expected of the employee to have the knowledge of what can be appealed and what is not. This includes gathering the information necessary to process the appeal accurately. Such as finding the correct diagnoses or procedure code, pulling of documentation such as fee tickets, EOB’s, and requesting medical records. The employee needs to have a clear understanding of the entire appeals process from start to finish and also be able to work effectively with the Liaison, and to document all activity on the patient invoice
  • Customer Service calls. Each employee is responsible for handling customer service calls. Employees must demonstrate excellent customer service skills, i.e. listening, problem solving, professionalism, etc. If unable to resolve, he/she must write up a complaint form when necessary and refer it to their Manager. Complete documentation of the call must be document in the IDX system
  • Projects. When asked to do a project, employee is required to complete the project within the specified time frame. Employee is responsible to gather and compile information relevant to the project, log the findings and a final documented report for Management
  • 12 Must be able to work as a team and collaborate and contribute to solving problems
  • 13 And other duties assigned
10

Patient Accounts Representative Resume Examples & Samples

  • Researches, analyzes and reconciles patient account receivables, refunds, claims processing, patient statements and revenue cycle management
  • Processes claims and patient statements including claims generation, coding, data entry, edits and follow-up
  • Maintains and applies knowledge of current requirements relative to managed care contracts, Medicare, Medicaid, Worker's Compensation, and departmental policies regarding uninsured payers and discounts
  • Evaluates accounts and prepares adjustments to refund payments and correct discrepancies as necessary
  • Serves as a primary resource for responding to patient/payer inquiries regarding account balances and claim status
  • Assists with orienting, training and mentoring team members
  • A minimum of 2 years of experience in patient billing or related area
11

Patient Accounts Representative Resume Examples & Samples

  • Works assigned Paperless Collection System (PCS) workfile by initiating follow up activity on accounts with third party payers
  • Meets established performance standard for accounts receivables follow up
  • Meets monthly collection goal
  • Documents collection activity in financial comments and assigns the appropriate action/rejection codes
  • Initiates Charge/Payment disputes to resolve coding and payment issues on accounts
  • Researches and processes basic insurance denials and appeals with minimal assistance
  • Contacts patient/guarantor/third party payer either by telephone or in writing to resolve open issues on account
  • Requests itemized statements and insurance claims
  • Updates patient insurance and demographic information
  • Requests patient collection and form letters
  • Researches and prepares documentation for adjustments according to the CBO Adjustment Policy
  • Reports trends or information pertinent to insurance claims, provider or systems issues to the Supervisor/Manager
  • High school diploma or GED Experience
12

Patient Accounts Representative Resume Examples & Samples

  • Assess outstanding accounts receivable and determine appropriate course of action to collect monies owed for assigned accoun
  • Related effectively with patients, insurance representatives, case managers and adjustors in order to resolve outstanding accounts receivable
  • Manage and prioritize multiple functions within the accounts receivable departmen
  • Review daily correspondence and determine appropriate course of action to collect monies owed for assigned accounts
  • Relate effectively with coworkers to resolve problems and issues identified during the course of business
  • Identify overpayments and perform necessary research to determine reason for overpaymen Complete refund paperwork with substantiated documentation for review by Practice Administrator
  • Develop an understanding of the ARC business model and effectively communicate/educate others
  • Other tasks and projects as assigned
  • Ability to create basic excel spreadsheets
  • Ability to perform routine mathematical calculations
  • Ability to operate personal computer and 10 key calculator
  • Ability to maintain accuracy
  • Ability to approach problems/decisions analytically
  • Positive attitude and professional demeanor
  • Follow clinic and OSHA safety rules and procedures
  • Uphold HIPAA regulations and maintain confidentiality
13

Patient Accounts Representative Resume Examples & Samples

  • Two to four (2-4) years of work experience, and/or equivalent education or training in medical claims management and reimbursement
  • Two (2) years of mainframe based PC and software experience, preferably HBOC, and knowledge of electronic billing systems; proficient in Microsoft Windows applications, including Microsoft Office; ability to interpret, and work from, computer reports and spreadsheets
  • Served as direct point of contact for customers in call center environment, or large organization, handling general questions and complaints
  • Types minimum of 45 words per minute, with 90% accuracy
  • Excellent analytical and auditing skills, and basic mathematics, for reconciliation of accounts
  • Knowledge of Fair Debt Collection Practices Act (FDCPA) and Health Insurance Portability & Accountability Act (HIPAA) regulations
  • Knowledge of third-party reimbursement regulations, with emphasis on Medicare and Medicaid programs
  • Basic knowledge of medical terminology, and/or related health care management courses, to enable interpretation of clinical documentation and appropriate coding
  • Bilingual desired, but not mandatory
14

Bwpo Patient Accounts Representative Resume Examples & Samples

  • Responsible for daily management of accounts receivable process and follow­up in the Billing System (Epic), including daily screening and correcting of claims for accuracy
  • Review, correction and completion of edit queues weekly for the particular insurance (s) assigned
  • Responsible for the appeals process. This also includes gathering the information necessary to process the appeal accurately. Such as finding researching payer websites, identifying the correct diagnoses and/or procedure code, pulling of documentation such as EOB's, requesting medical records, reviewing registration/eligibility and benefits, as well as documenting all work performed on the patient invoice
  • Customer Service calls. Responsible for handling customer service calls and demonstrate excellent customer service skills, listening, problem solving, professionalism, etc
  • Handle confidential information with accordance with HIPPA standards
  • A Minimum of 1 year experience in a healthcare
  • Once fully trained have a complete understanding of the entire appeals process from start to finish
  • Strong Interpersonal skills, service orientation and team work
  • Knowledge of Physician third party billing and collections preferred
  • Thorough knowledge of third party reimbursements preferred
  • Basic proficiency in Microsoft Word and Excel
15

Patient Accounts Representative Resume Examples & Samples

  • Collect past-due patient balances
  • Offer resolution of patient account balances through protocol available
  • Knowledge of Accounts Receivable collection process
16

Patient Accounts Representative Resume Examples & Samples

  • Minimum two (2) years of experience as a customer service professional
  • Call Center experience preferred
  • Experience in credit and collection strongly preferred
  • Healthcare experience strongly preferred
17

Patient Accounts Representative Resume Examples & Samples

  • Prior applicable experience in a hospital or physician office setting
  • Demonstrated computer proficiency
  • Strong communication and interpersonal skills to deliver exceptional customer service
18

Patient Accounts Representative Resume Examples & Samples

  • Clerical testing is required*
  • Ability to type 45 wpm with 70% accuracy
  • Ability to use 10-key by touch with 7,000 ksp
  • Basic Microsoft Excel and Word knowledge
  • Read EOBs (explanation of benefits)
  • Organizational skills
19

Patient Accounts Representative Resume Examples & Samples

  • Ability to use 10-key by touch with 7,000 kpm
  • Proficient with Microsoft Excel and Word
  • Read and interpret EOBs (explanation of benefits)
  • PeopleSoft (preferred)
20

Patient Accounts Representative Resume Examples & Samples

  • Two-four years work experience and/or equivalent education/training in Medical claims management and reimbursement
  • Two years of mainframe based PC’s and PC software preferably HBOC and knowledge of Windows applications and electronic billing systems. Proficient with Windows Applications, Microsoft Word and Excel. Ability to interpret and work from computer reports and spreadsheets
  • Served as a direct point of contact for customers in a call-center environment, or large organization handling general questions and complaints
  • Type a minimum of 45 works per minute (90% accuracy)
  • Excellent analytical /auditing skills and basic math for reconciliation of accounts
  • Knowledge of the Fair Debt Collection Laws and HIPPA regulations
  • Knowledge of 3rd party reimbursement regulations with emphasis on Medicare and Medicaid programs
  • Basic knowledge of medical terminology and/or related healthcare management courses to enable interpretation of clinical documentation and appropriate coding
  • Bilingual desired by not mandatory
21

Patient Accounts Representative, Senior Resume Examples & Samples

  • Process complex medical billing and collection claims
  • Maintain an up-to-date knowledge of trends and regulations to ensure compliance with established regulatory and Hospital guidelines
  • May train newer and/or lower-level Patient Account Representatives
  • Maintain all licensure/certifications required; maintain an up-to-date knowledge of medical billing and insurance claim standards
  • May lead the day-to-day activities of an assigned team. Provide leadership and direction to members of the department, performing those responsibilities in accordance with the Hospital's policies and applicable laws. May participate or hold responsibility for interviewing, planning, assigning or directing work, appraising performance, and resolving problems
  • Extensive knowledge of basic medical terminology and medical insurance terminology
  • Extensive knowledge of CPT-4, HCPCS, and ICD-9/10 coding
  • Extensive knowledge of UB-04 and HCFA 1500 billing requirements
  • Experience and knowledge of electronic transaction remark and adjustment codes
  • Basic math computational skills and the ability to use a 10-Key calculator
  • Ability to respond to questions in a tactful and professional manner
  • Ability to work collaboratively and meet the needs of competing demands
  • Ability to demonstrate accuracy and attention to detail on a regular basis
  • Ability to interpret accounts and records
  • Ability to utilize various coding software programs
  • Ability to serve as a resource for multiple physician practices
  • Ability to support the instruction of other Patient Account Representatives
22

Patient Accounts Representative Resume Examples & Samples

  • Previous experience in hospital admissions, business office or medical records preferred
  • Excellent communcitaion/organizational skills
  • Experience with Microsoft Office (Word, Excel, Access, Outlook, etc.)
  • Applicant must be at least 21 years of age
  • Ability to manage a fast paced environment
  • Must be polite, positive, and professional at all times