JOB TITLE:                  Patient Account Representative

REPORTS TO:             Business Office Supervisor/Business Office Manager/Chief Financial Officer

FLSA CLASS:              Non-Exempt

SALARY:          $15.43 - $19.29

 

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