Overview:
The Patient Account Representative is tasked with interpreting and understanding the Explanation of Benefits (EOB) for patients. The position operates with oversight and is accountable for receiving and recording payments on a patient's account. The role is proactive in addressing customer requirements to improve the overall patient satisfaction. The job is on an as-needed basis during the weekdays from 7:30 am to 4:00 pm.
Responsibilities:
- Manages the process of confirming insurance coverage, obtaining necessary authorizations, and determining the patient's financial obligations.
- Accounts will be confirmed within two business days following assessment or the day before the initial treatment appointment, as well as obtaining pre-authorizations in line with the deadlines for filing.
- Verification and validation of documents, approval, and clarification of patient payment obligations are conducted for all accounts. Accurate and prompt record-keeping is maintained in accordance with the specific requirements of each payer, both in the electronic information system and the patient's medical record.
- Recognizes instances lacking sufficient insurance protection.
- Helps with patient billing inquiries and refers them to financial counseling if needed. Recognizes available coverage and payment alternatives and relays details to the patient.
- Reviews account details, service dates, and chart data to comply with payer guidelines for securing payment.
- Establishes communication with the payer, referral provider, and other involved parties, and then proceeds to address and solve any payment-related challenges that may arise.
- Carries out additional tasks as required.
Qualifications:
EDUCATION:
Required:
- High School Diploma or equivalent
EXPERIENCE:
Required:
LICENSURE/CERTIFICATION/REGISTRY/LISTING:REQUIRED
