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Patient Account Representative

Florence, SC
TRACKING CODE

3430

JOB DESCRIPTION

Job responsibilities include those listed in competencies document

2. Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-

workers in accordance with our Service Excellence Standards and Core Values

3. Responsible for efficient and effective follow-up on third party payers to determine why payment has not been received

within a specified amount of time.

3. Reviews and interprets payer remittances for the purpose of verifying accuracy of payments, adjustments and to

determine appropriate action to be taken on denied claims, per guidelines.

4. Initiates appeals for denied claims per payer guidelines.

5. Reviews patient account files as necessary for accuracy of information, necessary signatures, pre-certification,

insurance benefits, and deposits made.

6. Submit electronic and hard copy claims in an accurate and timely manner and makes all necessary corrections to the

claims that do not pass the billing edits and payer requirements.

7. Contact payers for status of unpaid claims and research to ensure that questions and requests for information are

addressed in a timely and professional manner to facilitate resolution and reimbursement.

8. Assure timely, effective, and thorough management of claims to ensure full, expected reimbursement for services

provided.

9. Understands and complies with processes for corrected claims, per payer guidelines.

10. Answer telephone calls from patients and other callers promptly and with courtesy, demonstrating service excellence as

a top priority.

11. Communicates payer trends or problems identified as impacting reimbursement to the management team.

12. Ability to look up ICD-10 and CPT Treatment codes from online service or using traditional coding reference.

 

Job Requirements

Qualifications /Training:

· Six months to one year related experience and/or training; or equivalent combination of education and experience.

 

Licenses/Certifications/Registrations/Education:

· High School Diploma or Equivalent (GED) from an accredited school required

 

Physical Requirements: Refer to Occupational Risk Assessment

WORK SCHEDULE

Full time

JOB LOCATION

Florence, SC, United States

POSITION TYPE

Full time

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