Patient Account Representative - CMC

Position Summary:

The Patient Account Representative (PAR) will be responsible for efficient and effective follow-up on third party payer to determine why payment has not been received within a specified amount of time. The PAR will review patient accounts files as necessary for accuracy of information, necessary signatures, pre-certification, insurance benefits, and deposits made.

Qualifications:

Education:

• High school diploma required.
• Associate degree in a health-related field preferred.

Experience

• Minimum of three (3) years of experience in patient registration in an acute care setting required.

Licensure/Certification/Registration

• None

*Assessment of overall credit worthiness by review of a consumer credit report is required.*

Duties & Responsibilities:

• Submit electronic and hard copy claims in an accurate and timely manner and make all necessary corrections to claims that do not pass the billing edits and payer requirements.
• Contact payers regarding unpaid claims and research and/or ensure that questions and requests for information are addressed in a timely and professional manner to ensure resolution and reimbursement.
• Ensure timely, effective, and thorough management of claims to ensure full, expected reimbursement for services provided and will prioritize claims based on aging and outstanding dollar amounts or as directed by management.
• Answer phone inquiries regarding bills, charges and account status and compose routine correspondence, memos, letters, etc.
• Provide exemplary core customer service.
• Effectively utilize strong organizational skills.
• Consistently display effective verbal and written communication skills.
• Proficient understanding and use of technology/PC skills required.
• Regularly exercise independent judgement.
• Each employee who participates in the coding, billing or claims submission process, from the initial receipt of a physician order to the receipt of payment for services, shall accurately and honestly perform his/her functions to ensure that accurate claims are submitted, and the organization retains only those funds to which it is legally entitled.