PATIENT ACCOUNT REPRESENTATIVE - MEDICAL COLLECTIONS Responsible for payment posting, EOB management, Rejections and general patient account follow-up which includes incoming and outgoing calls to patients and/or payors. PAR1 will also assist with any other duties relating to patient account services. Employee is responsible for reading and comprehending company policies, as well as any specific policies associated with their job duties. ESSENTIAL DUTIES AND RESPONSIBILITIES (Additional duties may be assigned) Primary responsibility for working all patient responsibility balances, including: Working weekly insurance AR reports 31-60, 60-90, 90-120, 120 based on office metrics Documenting collection activities on account To conduct general account follow-up as it pertains to: Incoming/outgoing payor calls Incoming/outgoing patient calls Claims appeals or submission of any Secondary Claims Account inquiries Working the \"No-pay\" EOBs where there was non-payment due to: Information requests (from payor) Un-clean claim Patient ineligible at time of service Member not found Non-covered benefits and any other reasons for non-payment Research and resolve no-pay accounts which may result in; The account being appealed or re-billed to the payor Balance moved to patient responsibility Write-off adjustment (requires Supervisor approval) Send to coding review QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and /or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.EDUCATION and/or EXPERIENCE High School Diploma required and at least 2 years of recent billing/collections experience (or equivalent) for inpatient and/or outpatient services within areas of primary care and medical specialties. Demonstrate knowledge of CPT, ICD9, and HCPCS codes, as well as HIPAA, CMS and other related federal or state regulatory requirements. We are an equal opportunity employer and make hiring decisions based on merit. Recruitment, hiring, training, and job assignments are made without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, or any other protected classification. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance. Associated topics: account, authorization, billing, coder, desk, medical coder, medical coding, medical transcriptionist, number, transcription medical
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