Patient Accounts Representative
This is a contract position in the Medical Center.
• Initiates calls or online web contact to payors or guarantors to verify receipt of claims/statements and collect on
outstanding accounts receivables as specified by current collection policies and procedures
• Documents follow-up activities, conversations with payors/guarantors, information obtained via the web contact, and any
correspondence in the account notes.
• Ensures payments received by third party payors are correct and the correct contractual discounts/allowances have been
applied according to the contract matrix or government reimbursement rates. Ensures that all accounts associated with
that guarantor and payor relationship are resolved.
• Analyzes and assesses accounts for outstanding balances and makes prudent decisions on appropriate actions needed to
resolve the balance.
• Identifies and reports inaccurate reimbursement and contractual trends to Sr. Reps, Team Lead, or Manager.
• Refers problem accounts to Sr. Rep, Team Lead or Manager prior to accounts becoming 60 days old. Documents the issues
in detail and refers to Sr. Rep, Team Lead or Manager with a recommendation of action needed. Provides continual
•2 years revenue cycle experience Required
•General knowledge of government, commercial and managed care reimbursement methodologies and understanding of all federal, state, and local legal aspects of collection regulations.
• The knowledge of how managed care plans work and the requirements for insurance coverage and benefits.
• Account Representatives must have a strong math aptitude in order to be able to verify the appropriate reimbursement based upon the contract terms, benefits and/or government regulations.