Patient Account Rep

Bakersfield Behavioral Healthcare Hospital Bakersfield , CA 93307

Posted 2 weeks ago

Description;

The Patient Account Rep / must possess knowledge of the various payers i.e. commercial, Managed care, government plans and State programs, i.e. Medi-Cal/Medicaid and CCS. The Patient Account Rep is responsible for verifying patient insurance coverage, to ensure coverage by an individuals provider. He/she is responsible for entering data in an accurate manner, as it is his/her job to update patient benefit information in the insurance system and verify that existing information is accurate. This position requires the individual to spend extensive amounts of time on the phone and /or insurance companies websites to ensure that all benefits have been verified for determination of authorization requirements. This position also serves as a valuable resource to patients, providing them with pertinent information regarding their coverage. This position works with patients to explain coverage amounts provided by their insurance policy. This position also assist patients with payment arrangement plans for services that are not covered by their insurance companies and/or for those self-pay patients. Calculates and collects cash payments by using Medicare DRG/APC reimbursement table. Responsible for financially counseling patients at hospital bedside. Work closely with Case Management (UR) daily in regards to patient status changes; whether this would include patient type or insurance notification or insurance coverage. Must have excellent customer service and communication skills with the ability to effectively calm patients and be able to deal with distressed and/or agitated patients and their families.

Responsibilities:
  • Verify that sufficient information is available for accurate verification and eligibility. This step may require direct contact with the patient.
  • Call insurance companies and to verify and complete all insurance information and benefits.
  • Check if authorization is require
  • Enter the patient insurance information into patient financial system ensuring the selection is the appropriate payer and associated financial class.
  • goal for each patients insurance verification is complete and accurate. The insurance verifier will document the findings in the patient account and will contact the patient with either estimated co-insurance, co-pay and or deductible amounts due.
  • Calculate co-pay, and estimated co-insurance due from patients per the individual payer contract per the individual payer contract and plan as applicable.
  • Be familiar with individual payer guidelines and the process of collecting over the counter payments/deductibles/copay/co-insurance. Knowledge of payer contracts including Medicare, Medicaid and other government contracts and guidelines.
  • A/R, billing, insurance verification or customer service experience preferred

Requirements

  • Healthcare experience a must
  • Must have a minimum of 2 yrs of medical billing and follow up.
  • High School Diploma or GED
  • preferred Certificate in related field

Benefits

Medical, Vision, Dental and 401k

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Patient Account Rep

Bakersfield Behavioral Healthcare Hospital