Patient Account Representative II

LEADING NATIONALLY, DELIVERING LOCALLY

Patient Account Representative II

The Patient Account Representative II is the journey level class of this series and requires thorough knowledge of invoices, claims, insurance/Medicare billing, collections, and medical terminology in order to complete multiple tasks, and act as a liaison between the patient, physician, insurance companies, and third parties by processing and verifying invoices, ensuring payment of claims, and reviewing insurance reimbursements.  Under general direction, the Patient Account Representative II updates and resolves patient accounts for billing, evaluates patient financial resources, and establishes payment terms.  This position will perform the full range of duties, and may do so on a rotational or specialization basis of assignment.  Willingness to adapt to an evolving job description and expand your responsibilities as the company grows.  The Patient Account Representative II performs within established OSUP standards, applying knowledge and understanding of the practice plan.

OSUP offers a competitive salary and benefits package. EOE 
 
Primary Responsibilities: 
- Reviews, verifies, obtains and corrects patient demographics and insurance information, medical diagnosis, laboratory and other diagnostic services information, hospital service, applicable dates, required authorizations and certifications, signatures, and other information related to preparation and processing of patient bills, and eligibility of coverage.
- Enters patient data into and operates a computerized patient billing and registration system (IDX). 
- Researches and resolves missing or conflicting patient information. 
- Responsible for understanding and performing all aspects of the billing position; which includes, insurance follow-up, collections, refunds, denials, and charge and payment postings. 
- Works with patients regarding financial resources, eligibility for coverage, status and basis of charges, payment requirements, payment plans, collections, and related matters, by telephone and/or by mail.
- Evaluates and processes bad debt accounts; performs collection and follow-up activities; refers uncollectible accounts to collection services. 
- Requests completion of additional forms or information for denied claims or special processing requirements. 
- Reconciles accounts; adjusts balances to reflect denials, adjustments, payments, and other modifications to balances. 
- Update insurance on invoices by working the system generated reports. 
- Develops and maintains favorable relationships with new and existing patients in order to increase awareness and revenue. 
- Answer incoming patient calls and respond to patient correspondence.
- Attend regular compliance and billing training seminars. 
- Performs other related duties as required.

This position may be assigned to special projects or accountabilities when other priorities are identified.

Job Qualifications:
- Requires a High School diploma or GED
- Two or more years of claims processing, insurance billing, and/or medical terminology experience or training; or equivalent combination of education and experience.
- Must have experience with a computerized billing system. IDX experience is preferred. 
- Demonstrative effectiveness in conveying information both in writing and verbally. 
- Demonstrates an understanding of job responsibilities and uses appropriate knowledge and skills to effectively complete work. 
- Must have high level of interpersonal skills to handle sensitive and confidential situations. Position continually requires demonstrated poise, tact and diplomacy.
- Work requires continual attention to detail in composing, typing and proofing materials, establishing priorities and meeting deadlines.
- Analytical ability to gather and interpret data and develop, recommend, and implement solutions. 
- Demonstrates courtesy to others and promotes mutual respect. 
- Work effectively with individuals and team.
- Must be able to interact and communicate with individuals at all levels of the organization.


Most Essential Behavioral Skills:

 
Dealing with Ambiguity

Teamwork/Collaboration

Customer Service Orientation

Excellence & Accountability

Personal & Organizational Sensitivity (subset of effective teamwork)

Creativity/Innovation & Resourcefulness

Managing through systems: Planning, organizing, implementing, continuously improving

Balance & Perspective

 

Most Essential Technical Functional Skills:

 

Medical Terminology
IDX Billing System
Insurance billing and regulations

Collections

Data Entry