Patient Account Representative
Atlanta, GA - USA
Job Summary
Overview
Be inspired. Be valued. Belong. At Emory Healthcare
At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
- Comprehensive health benefits that start day 1
- Student Loan Repayment Assistance & Reimbursement Programs
- Family-focused benefits
- Wellness incentives
- Ongoing mentorship development leadership programs
- And more
Description
RESPONSIBILTIES:
- Assist with departmental workflow as needed. Identifies and notifies leadership of issues and initiates appropriate action for resolution. Serves as point person for employee questions.
- Maintains thorough understanding of insurance registration scheduling referrals authorizations and account follow-up.
- Provides support to leadership facilitating quality improvement by reporting problems concerns and opportunities for increased revenue and decreased denials.
- Assists in training and development of new staff members through the quality assurance process. Operates standard office equipment including telephone copier embossers and fax machine; prepares written correspondence and completes various forms.
- Reviews all accounts assigned for collection prior to during or after admission and discharge. Obtains demographic and insurance information for preadmission.
- Verifies benefits and pre-registers when appropriate. Initiates precertification when necessary. Verifies insurance as needed to resolve account balances. Obtains necessary financial data to set up patient payment arrangements when needed.
- Completes Financial Statement and gets approval on arrangements exceeding three months to completion. Works with staff to ensure best estimates of services.
- Performs progressive collection steps to discuss and clear balances on multiple accounts. Researches status of Medicare Medicaid and Blue Cross accounts through use of MEDA and BCH accepted batch listing reports EOB and other information. Bills third party payors when appropriate by hard copy or electronic submission. Performs special billing tasks such as combined and split bills as needed.
- Performs collection follow up support on assigned third party accounts. Coordinates activity with collections staff to ensure timely accurate rebill of accounts.
- Inquires about status of payments from insurance carriers. Ensures payment is received when expected; immediately pursues billing secondary insurance or billing the patient; applies appropriate allowance and adjustments.
- Recommends adjustments as appropriate to bring timely resolution to accounts.
- Maintains up-to-date knowledge of insurance plans and current contracts co-payments and deductibles.
- Interfaces successfully with insurance carriers. Maintains knowledge of current government and hospital contracts and working knowledge of co-payments and deductibles.
- Maintains and is familiar with UB92 and HCFA Billing Manuals. Coordinates classification for bad debt and charity. Maintains knowledge and is familiar with Healthquest system. Serves as a patient advocate during the cycle of the account.
- Communicates organizations financial policies to patients. Identifies patients who require early financial counseling intervention.
- Provides information regarding resources for patients who need financial help. Works with manager/supervisor to formulate plan for professional development. Attends educational in-services as appropriate.
MINIMUM QUALIFICATIONS:
- High school diploma or equivalent.
- Must have atleast four (4) years healthcare related experience. Knowledge of Medicare Medicaid and other contract payers (HMO PPO) preferred. CPAR (Certified Patient Account Representative) and/or CPFC (Certified Patient Financial Counselor) preferred for positions in hospital setting.
- Typing skills with a minimum of 35 wpm and good communication skills.
PHYSICAL REQUIREMENTS (Medium Max 25lbs): up to 25 lbs 0-33% of the work day (occasionally); 11-25 lbs 34-66% of the workday (frequently); 01-10 lbs 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking Occasional sitting Close eye work (computers typing reading writing) Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock Floor Surfaces Hot/Cold Temperatures Indoor/Outdoor conditions Latex Lighting Patient care/handling injuries Radiation Shift work Travel may be required. Use of personal protective equipment including respirators environmental conditions may vary depending on assigned work area and work tasks.
Additional Details
Emory is an equal opportunity employer and qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcares Human Resources at . Please note that one weeks advance notice is preferred.
Required Experience:
Unclear Seniority
About Company
"Have a Coke and a smile" means more to Emory University than it does to the rest of the world. The school, which has some 13,300 students and about 12,500 staff and faculty members, has a very low student-teacher ratio of about 7:1. It changed from Emory College to Emory University i ... View more