Position Title: Patient Accounts Representative
Supervisor: Patient Accounts Supervisor
Supervises: None

Mission, Vision, and Valued:

In the performance of one's job, the employee reflects the Mission by participating in the provision of convenient, cost-effective, quality surgical care.

Values: Confidentiality, Quality, Teamwork, Trust, Respect

Job Summary:

Responsible for accounts receivable, insurance verification and pre-certification, insurance follow-up, posting of insurance and personal payments, contacting patients/responsible parties for payment arrangements, and other accounting and reporting functions as assigned.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Key Areas of Responsibility:

• Posts insurance and personal payments to the appropriate patient's account as defined in the Business Office Instruction Manual.
• Prepares adjustment and refund sheets for approval to the Business Office Coordinator.
• Ensures complete follow-up with external agencies in order to provide or obtain information to resolve outstanding accounts receivables.
• Participates in the Surgery Center's Quality Improvement Program activities including identification of opportunities for cost reductions and efficiencies.
• Attends all the Surgery Center's meetings and educational opportunities. Maintains all required certifications.
• Maintains patient confidentiality at all times.
• Provides backup for all other business office positions as needed.
• Prioritizes job responsibilities and demonstrates flexibility to meet the needs of the Surgery Center and to facilitate optimum quality of patient care.
• Other duties as assigned by the Business Office Manager. Obtains insurance information and demographics to verify the patient's insurance eligibility and benefits prior to admission to the center.
• Contacts patients without insurance prior to admission concerning payment of their portion of bill and make appropriate arrangements.
• Processes all initial and secondary insurance billing to the appropriate third party payers. This will include re-submission and follow-up activities within a timely manner after charges are posted to a patient's account.
• Actively seeks timely payment of outstanding insurance claims and patient balances through diligent contact with third party payers and patients.
• Receives and responds to all patient and insurance company inquiries concerning billing.
• Works closely with all other positions in the business office/reception area.
• Ensures that all appropriate documentation is entered into HST system for future reference.
• Weekly reports billing and collection activity as required by the Business Office Manager.

Education, Experience, Licensure/Certification Requirements

• Minimum High School diploma or equivalent.
• Minimum of two related patient accounts, billing/collections experience, preferably in a health care setting.

Other Skills and Abilities

• Strong organizational skills and attention to detail.
• Demonstrated interpersonal communication skills in order to facilitate effective interaction with a variety of health care professionals and personnel.
• Ability to negotiate payment arrangements with patients and prepare cash deposits.
• Ability to work independently and to organize and to prioritize work efficiently to achieve the Center's goals.
• Keyboard skills of 50 wpm minimum.
• Ability to operate computer, various software packages (particularly Microsoft Office, Windows and Excel). Ability to operate equipment such as copy machine, fax machine and other common office equipment.
• Ability to compose correspondence with proper grammar. Pleasant telephone voice/manner.

Language Skills

• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to speak effectively before customers or employees of organization. Demonstrates good interpersonal communications skills. Must be able to speak and understand English as well as written communication.

Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully
• Develops alternative solutions; works well in group problem solving situations
• Uses reason even when dealing with emotional topics
• Technical Skills - Assessing own strengths and weaknesses; Strives to continuously build knowledge and skills; Shares expertise with others.
• Clinical Competencies - Tests and exercises to be completed prior to each evaluation.

working Conditions/Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to stand; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is regularly using computer. The employee is frequently required to walk. The employee is frequently required to sit, use phones and climb or balance and stoop, crawl. Specific vision abilities required by this job include close vision, distance vision, peripheral vision and ability to adjust focus.

• Normal hospital environment with exposure to chemical odors, cleaning solvents, and other hazardous materials.
• Exposure to possible injury when working with electrical equipment and lasers which requires care and following proper safety procedures.
• Light Lifting 20 lbs maximum with frequent lifting/carrying up to 10 lbs

Bloodborne Pathogens

Based on the OSHA guidelines for protection against occupational exposure to Hepatitis and HIV, this position is described as Category I. This means that this position has exposure to blood and body fluids. Policies are in place for Universal Precautions identifying exposure risks and appropriate barrier protection.

The above is intended to describe the general content and requirements for the performance for this position. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.