Under general supervision, Patient Account Rep oversees collection of patient revenues, maximizing reimbursements, cash flow and maintaining low receivables, while also maintaining excellent customer relations.
Reviews patient account documentation received from Admitting; identifies any missing information, corrects and follows-up with appropriate departments.
Identifies and resolves problem issues independently.
Reviews patient accounts and follow-up documents to determine the nature and extent of delinquency problems, and any actions taken by patients or third party payers; investigates delinquency cases to identify any special circumstances affecting payment delays
Receives and answers inquiries from patients and insurance companies regarding charges and/or billing discrepancies.
Reviews status of accounts receivable queues.
Promotes positive customer relations.
Utilizes hospital computer system to update, adjust, and process accurate patient accounts.
Reviews status of work queues and prioritizes job functions to ensure timely follow-up on patient accounts.
Verifies insurance eligibility and authorization as needed.
Reviews patient account with credit balances. Makes corrections, if needed and or submits refund request when appropriate.
Stays informed of updated insurance requirements and reimbursement practices.
Assists with training of new staff members.
Department Specific Competencies
Coordinates work activities of Medi-Cal eligibility worker.
Provides estimate of cost for hospital services.
High School Diploma/GED or Higher Education N/A
Number of Years Experience Type of Experience
1 Biller/collection experience in medical office or hospital.
License / Certification Requirements