PATIENT ACCOUNT REPRESENTATIVE- SOFHA OB/GYN

Company: State Of Franklin Healthcare Associates Pllc
Location: Johnson City
Posted on: May 21, 2023

Job Description:

SummaryProcesses unpaid accounts by contacting patients and third party payers. Assists patients with questions on accounts. Handles correspondence from third party payers appropriately. Requests reviews and appeals for denied claims. Assigns uncollectable accounts to collection agency or attorney. Knowledge of medical billing/collection practices. Knowledge of basic ICD-9 and CPT coding. Knowledge of insurance agency operating procedures and practices. Knowledge of governmental legal and regulatory provisions related to collection activities. Skill with computer applications and use of calculator. Ability to deal courteously with patients, co-workers and others. Ability to communicate clearly.Essential Duties and ResponsibilitiesPrioritizes delinquent accounts by age and dollar from Aged Receivables or other computer reports.Performs collection activities including contacting patients by telephone and resubmitting claims to third party payors. Follows company policy and procedures in collection activities.Evaluates patient financial status and establishes budget payment plans.Responds to correspondence by submitting copies of office notes, operative reports, etc. when requested.Reviews third party Explanation of Benefits (EOB) for appropriate payment.Reviews validity of denials; requests reviews and/or appeals.Answers patient questions and inquiries regarding their accounts.Identifies and resolves patient billing complaints.Reviews accounts for possible assignment to collection agency and makes recommendations to Practice Administrator.Participates in educational activities.Maintains strictest confidentiality.Performs related work as required.OtherCompiles information and prepares reports.Maintains records.Participates in educational activities.Follows organizational policies and procedures, including State of Franklin Healthcare Associates Compliance Manual, Code of Ethics and Business Standards, HR Policies and Procedures Manual, Team Member Handbook, OSHA Manual and any other policies or procedures for the job function, department, location or clinic.Performs other duties as assigned.EducationHigh school diploma or GED.ExperienceTwo years of collection experience in the medical field.Certificates, Licenses, RegistrationsN/ACompetenciesTeamwork: Maintains a positive working relationship with team members; acknowledges strengths and contributions of others; supports team goals and objectives.Compassion: Professional and respectful to patients, co-workers and others; remains calm when faced with challenging or difficult situations; manages and resolves conflict in a constructive manner.Extra Effort: Makes the best use of time during work hours; looks for opportunities to help others when assigned work is complete; goes above and beyond to ensure priorities are achieved.Excellence:Quality/Continuous Improvement: Ensures accuracy and completeness of work performed; contributes ideas and methods for improvement; receptive to suggestions and new ideas; accepts constructive feedback and demonstrates improvement.Job Knowledge/Technical Skill: Proficient in required skills for duties assigned; able to navigate and resolve unexpected situations.Productivity/Dependability: Responsive to direction and instructions; demonstrates ability to set priorities; completes appropriate quantity of work within assigned time limits; follows through on assignments and notifies supervisor if unable to complete; exhibits good attendance record (excluding approved leave); gives appropriate notification of absence and schedules time off appropriately.Working ConditionsWork is performed in a medical office environment involving contact with patients, physicians, staff, insurance carriers and other business partners. Occasional local travel between work sites and additional hours may be necessary.Physical RequirementsNot RequiredOccasionalFrequentContinuousWalkingXStandingXSittingXLifting up to 10 lbsX up to 25 lbsX up to 50 lbsX Assisted liftingXClimbingXBendingXPullingXPushingXVisionXColor VisionXHearingXSpeakingXChemicals/PPEXPathogens/PPEXOutside WorkX

Keywords: State Of Franklin Healthcare Associates Pllc, Johnson City , PATIENT ACCOUNT REPRESENTATIVE- SOFHA OB/GYN, Healthcare , Johnson City, Tennessee