Patient Account Representative en Peoples Community Health Clinic

FLSA Classification: Non-exempt 

Reports to: Patient Accounts Receivable Manager 

Job Summary/Objective: 

The Patient Account Representative files claims to third party payers, and posts payments.  Prepares patient billing statements and assists patients with accounts.    Performs all defined services and other related duties in accordance with the mission of Peoples Community Health Clinic (PCHC).

Protected Health Information Requirements/Access:

• This position will require the use or disclosure of protected health Information.
• This position will use the Payment class of protected health information.
• Restrictions on the protected health information for this position will follow the Privacy Policies of Peoples Community Health Clinic, Inc.
• Use or disclosure of protected health information not routinely available to this position will follow procedures assessed by or directed by management.

Essential Functions: 

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Files all third-party claims to primary insurance and follow up claims to secondary insurance.
• Posts insurance remittances to patient accounts.
• Posts insurance remittances to pharmacy accounts. 
• Performs encounter data entry.
• File all workman’s compensation and motor vehicle accident claims.
• Processes refunds.
• Processes unapplied payments.
• Reviews insurance Explanation of Benefits to ensure maximum reimbursement.
• Coordinates and implements the collection process.
• Performs collection procedures on identified accounts
• Works with patients and families to implement financial assistance program.
• Negotiates monthly payment agreement with guarantor.
• Provides customer service to internal and external customers.
• Supports a service-oriented atmosphere in accordance with PCHC Mission and Philosophy.
• Works to improve work processes and clinical outcomes including health disparity and quality improvement collaboratvies.
• Follows policies and procedures.
• Develops and maintains own competence.
• Maintains a safe working environment and practices safe working habits.
• Assists in control of PCHC resources.

Competencies:

• Strong analytical and problem-solving skills
• Communication – listening, speaking, writing, and reading comprehension
• Ability to work with diverse groups of people 
• Ability to work with a large degree of independence
• Adaptability and flexibility
• Ability to perform multiple tasks with frequent interruption. 
• Ability to be very detail oriented. 
• Strong public relations/customer service skills
• 10-key calculator.  Working knowledge of MS Office Products (ex. Excel, Word, Access, Power Point) and Windows Platform.  Must be comfortable moving within an EHR computer system regularly.
• Maintains strict confidence 
• Planning and organizing.

Supervisory Responsibilities:

• Not applicable.

Patient Population:

• Not applicable. 

Work Environment/Personal Protective Equipment:

Physical Demands:

This position requires continuous sitting (67% - 100% of shift); occasional walking (1% - 33% of shift); continuous finger dexterity and use of hands/arms for repetitive movement (67% - 100% of shift); requires 20/20 near vision

Position Type/Expected Hours of Work:

This is a full-time position. Typically work hours and days are between Monday and Friday,8:00 a.m. to 5:00 p.m. and some flexibility in hours is allowed. Responsibilities occasionally may require irregular hours as deemed necessary. This may include an adjusted work schedule, long days, and early morning or late evening hours in order to meet client scheduling demands. The employee must work a minimum of 40.0 hours each week to maintain full-time status. 

Travel:

Occasional driving might be expected for this position.

Education and Experience:

• High school diploma
• Minimum of 3 years medical office experience, or 1 year accounting processing experience

Licensure: 

Other Duties:

The statements contained in this job description reflect general details as necessary to describe the principal functions of this job, the level of knowledge and skill typically required, and the scope of responsibility. It should not be considered an all-inclusive listing of work requirements as individuals may perform other duties as assigned.