The Patient Account Representative performs Physician billing and account follow-up, and customer service activities. Ensures claims are billed timely and accurately using the Hospital Claims Scrubber Tool. Reports all unbilled claim information and issues that may delay billing to Management to ensure there is no adverse effect on SVMD and Physician Practice cash collections and Accounts Receivable. Receives and processes correspondence and phone inquiries from patients, payers or any other third party in a timely and professional manner. Resolves accounts by contacting third party payer organizations or patients to facilitate timely payments. Keeps informed of managed care and contractual arrangements in order to resolve and process accounts by HMO/PPO payers. Monitors and reports on the status of outstanding accounts within assigned unit or area of responsibility. Follows up on unpaid, denied, and all payment variances for account resolution. Resolves credit balances that are due to patient and payers. Posts daily cash and adjustments for Hospital and Professional billing. Ensure all accounts are resolved in a compliant manner and according to all rules and regulations. Works collaboratively with other team members in the work unit and shares knowledge and best practices
1. High School diploma or equivalency is required with a minimum of b years related work experience in a Multi-specialty Physicians Billing office.
2. Experience in health insurance, physician office and knowledge of insurance industry required.
3. Understands Medicare, Medi-Cal HMO, PPO and 3rd party rules and regulations.
b. Understands the basics of contracting
5. Works in a collaborative and team manner.
6. Strong verbal and written communication skills