Patient Account Representative - Customer Service

Responsible for working claims from start to finish to fully support the patients' needs. Maintains A/R at acceptable aging levels by prompt follow-up of unpaid claims, denied claims and underpaid claims. Provide information over the phone for all patients billing questions directed to the central business office. Review all credit balances for possible refunds. Perform all duties in a manner which promotes team concept and reflects the clinic's mission and philosophy.

SCHEDULE: 8:00 AM TO 4:30 PM MONDAY THROUGH FRIDAY

THIS POSITION IS ON SITE FOR APPROXIMATELY SIX MONTHS

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Answer calls and responds to patient inquiries and/or problems regarding bills in an accurate, prompt, and courteous manner.

• Identify delinquent accounts and contact patients to negotiate a payment plan.

• Respond to collection agency correspondences and agency assignment paperwork.

• May review returned mail to skip trace.

• Thoroughly and timely work accounts in work queues as defined by policies and procedures.

• Respond to any correspondence attached to patient statements.

• Process bankruptcy and probate accounts.

• Evaluate patient eligibility for financial assistance adjustment.

• Receive patient requests for information and adjustments. Initiates resolution as identified in department policies and procedures.

• Post all insurance payments in a timely and accurate manner.

• Post all insurance denials in a timely and accurate manner.

• May process the insurance claims correspondence and mail returns.

• Read and interpret EOB's (Explanation of Benefits)

• Provide quality customer service and resolution to callers' concerns

• Process appropriate refund in accordance with department policies and procedures.

• Present unresolved patient concerns to the Team Lead for resolution immediately with related documentation.

• Document account activity accurately and promptly during or immediately following each patient encounter on the telephone or in person.

• Responsible for the accurate and timely submission of claims, denials, appeals and re-bills of insurance claims.

• Responsible for the analysis and necessary corrections of patient accounts as it pertains to clean claim submissions, re-bills or appeals.

• Responsible for maintaining work queues.

• Responsible for identifying potential errors that require necessary coding reviews, corrections or adjustments.

• Responsible for telephone and/or written correspondence with insurance companies for claims follow up.

• Responsible for correctly identifying and updating various types of insurance entry information.

• Maintain basic understanding and knowledge of health insurance plans, policies and procedures.

EDUCATION AND SKILLS

• High school diploma or equivalent.

• Minimum of 1-3 years experience in health care accounting within a medical office preferred.

• Knowledge of private billing and collections regulations experience preferred.

• Must be a proactive problem solver, foster teamwork and trust, be highly skilled in prioritizing, organizing, planning, communication and staying on track.

• Demonstrated customer service expertise.

• Knowledge of commercial insurance contract practices, third party billing and billing to private clients preferred.

• Keyboarding minimum 40 wpm.

• Accurate 10 key by touch and familiarity with Microsoft Word and Excel.

• Excellent organizational skills required.

• Must be able to work in a highly demanding atmosphere, with a variety of personalities within a fast paced environment.

• Excellent verbal and written communication skills, and extensive hands-on computer background.

Pay Range:

$19.22 - $26.91

The above information is intended to indicate the general nature and level of work required in this position. It is not designed to contain or be interpreted as a comprehensive description of all duties, responsibilities, and qualifications required of those assigned to this job.

We offer a competitive Total Rewards Program. Eligibility for benefits is dependent on factors such as position type and FTE. Benefit-eligible employees qualify for benefits beginning on the first of the month following one month of employment. Vancouver Clinic offers medical, dental, vision, life insurance, AD&D, long term disability, health savings account, flexible spending account, employee assistance program, and multiple supplemental benefits (voluntary life, critical illness, accident, hospital indemnity, identity theft protection, legal services, etc.). We also offer a 401k retirement plan, with employer contributions after your first year of employment. Benefits-eligible employees accrue PTO and Personal Time based on hours worked and State worked, totaling 120 hours in the first year for full time staff and 200 hours in the first year for full time supervisors and above, increasing in subsequent years. PTO and Personal Time accruals are pro-rated by FTE/hours worked. Non-benefits eligible employees will accrue Personal Time based on hours worked and State worked. Employees will also enjoy up to six paid holidays per year, depending on schedule. Contact your recruiter for more information.

Vancouver Clinic is proud to be an Equal Opportunity Employer. Vancouver Clinic does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, gender identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Vancouver Clinic is an alcohol and drug-free workplace. Offers are contingent on successful completion of background screen and immunization requirements.