Patient Account Representative
Job Category: Medical Coding and Billing
Full-Time
Marietta, GA 30066, USA
Job Details
Essential Job Functions:
· Obtain surgery authorization/precertification prior to scheduled surgical procedures
· Verify patient insurance benefits for scheduled surgical procedures via telephone or electronically to determine eligibility, copay, coinsurance, out of pocket and deductible information
· Contact patients via telephone to quote insurance benefits, explain payment expectations, collect prepayments or make payments arrangements one week prior to scheduled surgical procedures
· CPT, ICD-10 and Medical Terminology
· Obtain Retro or Backdated authorizations when needed or requested
· Documents benefits, payment arrangements and authorizations in the system
· Create daily payment logs for the surgery center
· Respond timely to patient, coworker, clinical staff and insurance company calls and emails
· Perform essential office duties (answering suite doors, sorting faxes, loading paper/toner, etc.)
· HIPAA Compliance relating to all patient confidentiality (to include daily shredding of sensitive information)
· Maintain proper office etiquette with the ability to remain flexible and work collaboratively to resolve challenges
· Logging into phone queue daily (answering both queue and direct calls) unless on approved break or lunch and logging out at end of shift
· Utilize company computers for business use only
· Adhere to departmental policies regarding electronic devices and accessories (earbuds, videos and social media sites)
· Strong attention to detail and organizational skills and multitasking abilities
· Duties and responsibilities may be added, deleted or changed at any time at the discretion of management, formally or informally, either verbally or in writing
Competencies:
· Ability to comprehend Deductible, Copay, Co-Insurance and Out of Pocket Maximum analyze and communicated as such.
· Consistently communicate in a calm, orderly, and non-threatening manner
· Ability to manage multiple priorities and work with interruptions.
· Good organizational and time management skills
· Must possess strong customer service and interpersonal skills to interact effectively with patients and insurance company representatives
General Minimum Education and Background Requirements
· High school diploma or GED
· Minimum (2) years of experience in a medical office setting highly preferred. (i.e. ambulatory surgery center, hospital, doctor’s office).
· Basic medical and billing terminology, CPT, ICD-10 and insurance company terms
· Working knowledge of Word, Excel, Outlook and Internet
· Experience in Clearwave, NextGen and insurance company sites and portals
· Excellent customer service, written and verbal communication skills
Minimum Demonstrated Skills
· Knowledge of organization policies, procedures and systems.
· Knowledge of contractual management practices
· Good mathematical skills a must.
· Ability to work effectively with staff, physicians and external customers. Must display teamwork attitude and good inter-personal skills.
· Must be able to work effectively under high levels of stress and under deadlines
· Knowledge of medical billing processes.
· Knowledge of health care insurance claim practices and compliance.
· Knowledge of computer systems, programs and spreadsheet applications.
· Skill in gathering and reporting claim information.
· Skill identifying denial reasons and submitting appeals
· Skill in use of multiline phone system.
· Skill in written and verbal communication and customer relations
· Ability to adhere to organizational standards and key behaviors (respect, teamwork, professionalism, communication, professional growth and development)
· Ability to maintain confidentiality of business / work information.
· Ability to utilize available resources to update patient account information.
Physical Requirements: Requires sitting and standing associated with a set office environment. Manual dexterity using calculator and computer keyboard, good eye-hand coordination, adequate vision and hearing needed in daily work. It is necessary to view computer screens for long periods. Good voice quality, effective verbal communication skills, and a friendly voice tone required. Occasional lifting of files or paper weighing up to approximately 30 pounds is required. Must be in good mental and physical condition to withstand the medium to high levels of stress and demands of a mentally and physically active position
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience:
- Customer service: 2 years (Required)
- healthcare: 1 year (Required)
- Medical coding: 1 year (Required)
Work Location: In person
