Patient Account Representative
JOB TITLE: Patient Account Representative
REPORTS TO: Business Office Supervisor/Business Office Manager/Chief Financial Officer
FLSA CLASS: Non-Exempt
DATE REVISED: February 1, 2018
SUMMARY:
The Patient Account Representative is assigned to a specific team and is responsible for following MedStar’s procedures and/or productivity expectations specific to each individual unit.
ESSENTIAL FUNCTIONS:
- Process and respond to all patient and insurance correspondence.
- Add or correct any billing information to the A/R system, i.e., Medicaid, Medicare number, insurance information, etc.
- Schedule any needed claims for billing.
- Process return Mail (paper & electronic)
- Send letters to patients requesting necessary information, such as supplemental insurance information, letters of medical necessity, Medicare explanation of benefits, etc.
- Send letters to patients requesting payment on accounts.
- Maintain appropriate physical and mental health required to perform the essential functions of this job.
- Regular and timely physical attendance during assigned work hours.
- On-call and overtime work required in emergencies and at other times as directed or assigned.
ESSENTIAL SKILLS:
- Promote a positive work environment.
- Work effectively as member of the MedStar team.
- Complete other projects and/or responsibilities as assigned by the Business Office Manager or Chief Financial Officer.
- Ensure confidentiality of medical and all other discretionary information.
JOB DUTIES:
Verify
- Verification of all required information to ensure appropriate billing
- Apply complete and accurate updates to the billing system
Balancing / Returns / Corrected
- Balancing the ePCR’s with daily CAD Report to account for any missing trips
- Processing all reports applicable to determining dry runs, multiple patient transports, specific call types, etc.
- Data entry of certain required information into the billing system.
- Consistent processing and/or monitoring of those trips in the Quality Assurance Workflows to ensure corrections are being made, etc.
- Return charts to medics for corrections as needed.
Billing
- Review of all completed ePCR’s to determine complete and accurate information to ensure appropriate documentation and / or billing guidelines are being met.
- ICD-10 Diagnosis Coding
- Complete and Accurate Date Entry of all Information Required for Appropriate Billing of a Trip
- Return accounts to the verify team as need for updates
Follow-up & Advocacy
Collections/Handling Patient Accounts
- Monitor and maintain the accounts receivables by processing aging reports and/or specific workflows as indicated by the MEMSA collection procedures for each follow-up unit.
- Process all denials and appeals in a timely manner
- Follow through with calls and other collection procedures as assigned.
- Document all attempts at contacting responsible parties for outstanding accounts.
- Refer accounts to one of the BO Supervisor or Billing Manager when necessary.
- Receive incoming telephone calls regarding accounts.
- Return messages daily.
- Assist walk-in customers as needed.
- Document customer complaints regarding service or billing and refer to your Supervisor, who forwards them to the Administrative Assistant for processing.
WORKING CONDITIONS:
- Air conditioned office environment
PHYSICAL DEMANDS:
- Sit for extended periods of time
- Walk, stand, bend, squat, twist and reach
- Simple grasping and fine manipulation
- Extended keyboarding
MINIMUM REQUIREMENTS:
- Must not have been excluded by the OIG to Participate in Federally Funded Heath Care Programs
- High School Diploma or GED
- At least three (3) years of experience in data entry and medical billing
- Knowledge of medical terminology
- Knowledge of medical insurance claim filing processes
- Ability to use 10-key by touch and type 40 wpm
- Experienced in the use of personal computers
- At least one (1) year of previous office experience in a structured environment
- Effective communication skills
- Strong customer service skills
- Strong ability to multi-task and work well under pressure Ability to perform multiple tasks simultaneously with a high degree of accuracy
- Must not have been excluded by the OIG to Participate in Federally Funded Heath Care Programs
PREFERRED REQUIRMENTS:
- Experience in Ambulance ICD-10 coding
- Knowledge of Ambulance Medicare policies and procedures
- Knowledge of Ambulance Medicaid policies and procedures