PRIMARY FUNCTIONS

The Patient Accounts Representative is responsible for assisting patients in understanding their billing, financial obligations, and estimates for cost of care.  This position performs follow up work on insurance types for selected financial classes, including phone contact with insurance companies and patients, assists with prior authorizations of procedures, prepares good faith estimates and cost estimates for patients, and stays abreast of carrier communications and monitors accounts for negative trends.

This position also maintains files or medical records for organizations patients and complies statistics for use in reports and surveys.

Complies with department and organization-wide policies, Critical Access Hospital requirements, Safety and Infection Control, all and Federal and State of Nebraska regulation related to the performance of CCCH operations and requirements of the Compliance Program. Participates in professional growth and development.

QUALIFICATIONS 

Education and/or Experience

High School diploma or general education degree (GED) required

One to two years of medical coding/billing experience is preferred, but willing to train.

GENERAL REQUIREMENTS 

Demonstrates commitment to the organizational mission, vision, and core values

Maintains patient confidentiality at all times

Evidence of good grooming, professional manner and conduct

Ability to exercise professional judgment, courtesy, and professionalism in daily interactions with others

Communicates effectively both orally and written to all disciplines

Possesses ability to make independent decisions and changes

Demonstrates teaching skills, understanding and language skills

Exhibits excellent telephone and computer skills/knowledge

Proper use of the EMR

Serve as a role model to colleagues, students and other care providers

Actively participate in continued learning opportunities and continued self-development pertinent to the duties of the job

Able to operate all equipment correctly and safely

Participate in QA programs, as needed

Practices Standard Precautions

Ability to sit, stand, bend and lift as job requires with the possibility of prolonged standing

Able to adjust to frequent interruptions

Risk of exposure to infectious waste and diseases

Attends and participates in department designated meetings

Able to perform other related duties as assigned

SIGNIFICANT DUTIES 

Maintains a thorough understanding of the Registration modules in the information computer system to register patients

Able to correct or update patient’s information in the computer system

Compile data for occupancy and census records

Schedule appointments

Check patient’s insurance eligibility

Obtain and scan insurance cards, HIPAA documentation and patient ID’s, signed statements

Ability to work in all registration areas as needed

Coordinate communication between patients, family members, medical staff, and administrative staff

Interview patients or their representatives to identify problems relating to care

Refer patients to appropriate health care services or resources

Explain procedures and services to patients using medical or administrative knowledge

Ability to complete a patient financial screening for financial reimbursement

Welcomes patients by greeting them with enthusiasm, in person or on the telephone

Directs patients to appropriate person and or room

Maintains safe and clean reception to comply with procedures, rules, and regulations

Answers, screens, and forwards incoming calls

Ensures consistency is being conveyed by documenting and communicating actions and continuing needs

Accepts and processes payments from patients

Completes other clerical receptionist duties such as filing, photocopying, transcribing, and faxing

Handles patient complaints or problems and guides every situation with care