Patient Account Representative Senior


Exemption Status: Non-Exempt
Salary Grade: C04
Job Code: 7234

This is a description of a Staff Position Classification. It is not an announcement of a position opening. To view descriptions of current openings, please go to jobs.ou.edu and Search Postings to view positions that are currently accepting applications.

The following statements are designed to outline the general functions and typical responsibility levels associated with positions in this classification. They are not intended to serve as an exhaustive list of specific duties or requirements for individual positions assigned to this classification.
Essential Duties/Responsibilities:

Under general supervision, may participate in any or all aspects of the patient processing and accounts receivable functions of the organization including billing, charge entry, collection, registration, scheduling, follow-up, coding, payment posting, and credit balance resolution. May reconcile daily IDX system receivables reports. May balance monthly transactions and provide summaries to faculty and department administration.
·        Reviews patient admitting records and extracts information. Enters patient identification and demographic information to billing system. Contacts agency representatives to verify type and extent of insurance coverage.
·        Reviews source documents to determine if sufficient data is present for processing. Transcribes and/or verifies data from source documents in order to enter to the system. Batches and enters charges and generate cash totals. Balances batches by comparing batch proofs to source documents.
·        Acquires information from the organization for the patient, insurance carriers, or other entities. May interact with hospital patient accounting or records to obtain patient demographics or other billing information. Operates hospital information system to obtain demographics, insurance, and status of approvals or denials. Completes inpatient and outpatient documents processing. Assists with resolving problems with IDX billing. Maintains records of charges, payments, and third party charges.
·        Answers patient¿s questions. Handles correspondence regarding collection activity and records results. Identifies patient accounts for collection action. May receive patient payments and/or issue payment receipts. Initiates contact with patient and/or third party carriers if there is a delay in responding to statements or claims.
·        Record CPT and ICD-9 codes on billing forms.
·        May process incoming/outgoing mail. May receive incoming calls and resolve issues. Records on the computer billing system any results from mail or telephone contact. Contacts insurance carriers regarding non-payment and/or improper payment of claims. Reviews denials. Interfaces with patients, physicians, and others regarding billing operations and funds.
·        Posts receipts to proper patient accounts.  Posts denials. Compare batch proofs and source documents for accuracy. 
·        Assists with reviewing and balancing IDX transaction reports. Reconciles daily IDX receivables reports. Prepares billing statements from statistical data.
·        Reviews daily billing and accounts receivable credit balance reports. Prepares daily refund check requests. Prepares daily credit balances other than refunds. Posts refund checks to patient accounts and mails refund checks with supporting documentation.
·        Performs various duties as needed to successfully fulfill the function of the position.


Minimum Requirements:

Education:

Required: High School Diploma or GED

Experience:

Required: 24 months experience in Medical Billing, Medical Collections, and Medical Billing Systems (IDX or other billing system).

Certifications or Licenses:

N/A

Required Knowledge, Skills, Abilities:


  • Knowledge of medical terminology and billing.
  • Strong analytical and problem-solving skills.
  • Excellent organizational skills.
  • Effective communication skills.
  • Exceptional customer service skills.
  • Detail-oriented.



Working Conditions:

Standard Clinic Environment