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The patient accounts representative is responsible for processing ICD-10 and CPT coding according to federal, state, managed care, and third party payer guidelines for services rendered.
Key Duties and Responsibilities
• Adheres to practice’s Risk Management and Accounts Receivable processes
• Assists in insurance claims management
• Assists in patient payment collections and payment arrangements
• Communicate with all involved parties to clarify billing issues and facilitate payments
• Consults with team lead and team members to solve billing and collection questions or issues
• Ensures claims have been authorized for all services being charged
• Keeps the AR within provided benchmarks
• Function as contributing team member while meeting deadlines
• Investigates and seeks resolution of claim denials, daily
• Maintain an accurate, legally compliant medical record
• Performs day end, month end, and year end procedures
• Performs similar and incidental duties as assigned
• Perform coding and billing tasks on correct health information technology (HIT) system.
• Post payments and denials, verify, balance and prepare daily deposits
• Prepare reports and forms as directed and in accordance with established policies
• Provide excellent and professional customer service to internal and external customers
• Review insurance payments for accuracy and compliance with contract discounts
• Review denials or partially paid claims and resolve any discrepancies
• Utilize electronic health record (EHR) and paper patient records to perform billing duties
• Verifies fee ticket charges are documented in medical records
• Verifies that all charges for services are coded with the appropriate CPT/ICD-10 codes
• Exceptional customer service skills
• Great interpersonal skills; demonstrating patience, composure and cooperation; working well with all patients, physicians and staff.
• Ability to adapt well to change.
• Be able to multi-task in a busy environment.
• Maintain professionalism in stressful situations.
• Understanding of and adherence to all safety, risk management and precautionary procedures, including the consistent respect for confidentiality (HIPAA).
Education / Experience
• High school diploma or GED
• Completion of medical terminology or anatomy/physiology course, CPT/ICD-10 and insurance billing course.
• One year of previous insurance billing or bookkeeping experience in a healthcare setting within the last three years preferred
• Bookkeeping or accounting course preferred
• Must be able to communicate effectively
• Must have knowledge of medical terminology
• Must be able to organize work and establish procedures
• Must be able to speak, read, and write the English language
• Skill in using a computer
The work environment/physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Required to sit, stand and walk continuously
• Occasional lifting of up to 25 pounds
• Frequent stooping, bending, pushing, pulling, reaching, and occasional kneeling, crawling and squatting
• High frequency of telephone usage and computer keyboard
• Ability to see, hear, and speak continuously at a level to meet all essential functions of the job
• Ability to prioritize and process with accuracy
This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.
The work environment/physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.
How we are protecting team members from COVID-19? Employee and patient health and safety is our top priority. At Proliance, we are adhering to CDC, State and local orders regarding COVID-19 and have implemented processes and precautions across our facilities to prevent the spread of COVID-19.
Following the most recent vaccination mandate for healthcare workers in Washington State, and our commitment to the health and safety of our employees and patients, all Proliance employees will be required to provide proof of full vaccination upon hire, or proof of a medical or religious exemption.
Proliance Surgeons offers a generous benefits package including Medical/RX, Dental, Vision, 401k with profit sharing and more! Plus ALL of our employees enjoy the free perks of our employee purchasing program offering a variety of discounts on purchases made every day – including cell phone service!
Proliance Surgeons is proud to be an equal opportunity employer. We are committed to creating an inclusive environment, and we welcome and encourage people of all backgrounds, perspectives, experiences, and skills to apply.
All employment decisions at Proliance Surgeons are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. We will not tolerate discrimination or harassment based on any of these characteristics.