Patient Account Representative- Business Office - Full Time/Days - Req#2097433910
Antelope Valley Medical Center
Lancaster, CA
Health / Beauty / Fitness
Brief Description
Job Objective:
Under the supervision of the Collection Supervisor, Director, or designee, performs patient account follow-up, credit balance review and resolution, keeping the hospital's accounts receivable as accurate as possible.
Duties and Responsibilities:
Knowledge
Education
Requirements
Education and Experience:
Education
Job Objective:
Under the supervision of the Collection Supervisor, Director, or designee, performs patient account follow-up, credit balance review and resolution, keeping the hospital's accounts receivable as accurate as possible.
Duties and Responsibilities:
- Insurance Follow-up, as assigned
- Contact insurance carriers regarding outstanding balances until resolution
- Resubmit bills to insurance carriers as needed
- File insurance carrier appeals for payment and/or denial disputes
- Validate accounts for accurate payments, discounts, and contractual adjustments
- Reply to insurance carrier correspondence as appropriate
- Answer in-coming calls, resolving patient, insurance, and/or vendor issues timely
- Patient Follow-up, as assigned
- Answer in-coming calls, resolving patient, insurance, and/or vendor issues timely
- Contact patients regarding outstanding balances until accounts receivable resolution
- Resubmit bills to insurance carriers as needed
- Validate bills for accurate discounts and contractual adjustments
- Set up payment plans and monitor until resolution
- Refer uninsured accounts to Pre-Collection
- Assign patient accounts to Bad Debt when appropriate
- Communicate with TPL agencies and attorneys
- Processes bankruptcy notifications
- Review charity care applications and refers to the Director, or Collection Supervisor, for approval or denial
- Credit Balance, Physician Payment, Trauma Billing, Client Billing, and Miscellaneous Reports Processing, as assigned
- Process refund requests for patients and insurance carriers
- Process uninsured claims for specialty physicians
- Track and trend Medicare Bad Debt assignments for the Cost Report
- Research unidentified checks for posting corrections
- Cancel Medicare and Medi-Cal eligible accounts from collection agencies, as assigned
- Assist with other duties as assigned, within skill sets and abilities
Knowledge
- Working knowledge of HMO, PPO, Commercial, Medicare HMO, Medi-Cal HMO, Government, and Workers' Compensation reimbursement
- Working knowledge of Managed Care contract language and interpretation
- Working knowledge of Microsoft Office applications
- Knowledge of basic arithmetic
- Knowledge of Proficient in basic personal computer
- Knowledge of Proficient in the use of a calculator
- Proficient in the operation of scanners, copiers, and fax machines
- Ability to handle stress
- Ability to manage a heavy caseload in an organized and efficient manner
- Ability to recommend appropriate account adjustment and write-off suggestions
- Ability to recognize potential accounts receivable related problems and offer solutions to management
- Ability to maintain a working relationship with other departments within the organization
- Ability to review all billing transactions for accuracy, discrepancies, and appropriate charges
- Ability to document account information at time of account follow-up
- Ability to run accounts receivable reports as needed
- Patients Come First – We listen actively and communicate with our patients and families, placing safety as a top priority.
- Accountability & Ownership – We fully complete tasks, are transparent, effectively communicate, and recognize that what we do reflects on us.
- Teamwork – We build trusting relationships, promote a sense of community, and are respectful of everyone. Success is about the whole team.
- Integrity & Honesty – We tell the truth at all times, speak up when something is wrong, and do the right thing when no one is looking.
- Excellence – We take pride in our work, are goal-oriented, and on a never-ending quest for top tier quality.
- Initiative & Innovation – Our can-do attitudes, creativity, and resourcefulness empower us to improve the patient’s experience, solve our own problems, make timely decisions, and look for opportunities to add value.
- Tenderness & Compassion – We have genuine empathy, show kindness, and encourage and advocate for each other.
Education
- High School graduate or equivalent
- Minimum 1-year previous Commercial, HMO, PPO, Medicare HMO, Medi-Cal HMO, Government, and Workers Compensation billing and Insurance follow-up experience
- Will consider 2-years’ recent acute care hospital Business Office experience
- None
- Ability to adhere with AVH Absenteeism and Tardiness Policy
- Ability to adhere with AVH Leaves of Absence Policy
- Ability to adhere with AVH Paid Time Off (PTO) Policy
- Ability to adhere with AVH Recording of Hours Worked Policy
- Ability to adhere to the department dress code
- Ability to organize work and establish priorities
- Ability to expand on own initiative in performance of duties
- Skill and ability to follow the telephone etiquette/standards
- Conforms to AVH Standards of Excellence
- Ability to function effectively under pressure and meet time parameters
- Ability to communicate effectively while maintaining good working relationships with co-workers, managers and other hospital staff
- Ability to adhere to the normal standards of courtesy and conduct as defined under the rules of hospitality at AVH
- Ability to maintain the confidentiality of patient, hospital and department information
- Ability to adhere to safety rules and regulations
- Safely and effectively uses all equipment necessary to carry out duties
- Ability to interpret and function under hospital and department policies and procedures
- Conforms with required and appropriate Joint Commission requirements
- Conforms with and supports hospital quality assurance and improvement guidelines
- Ability to participate effectively in department and hospital staff education
- Display a willingness to work as a team player
- Ability to give and support the highest level of patient/customer satisfaction at all times
- Supports and adheres to the values and mission statement established by the AVH Board of Directors
- Ability to demonstrate knowledge and understanding of the Compliance & Integrity Program and its established policies.
- Ability to follow the Code of Conduct
- Primarily works in a climate-controlled area
- Sitting 80% of time on duty
- Tolerate repetitive arm and hand movements
Requirements
Education and Experience:
Education
- High School graduate or equivalent
- Minimum 1-year previous Commercial, HMO, PPO, Medicare HMO, Medi-Cal HMO, Government, and Workers Compensation billing and Insurance follow-up experience
- Will consider 2-years’ recent acute care hospital Business Office experience
- None
About the company
Company website•Hospitals and Health Care
Antelope Valley Medical Center, a facility of Antelope Valley Healthcare District, is a 420-bed full-service, acute care, medical and surgical hospital. Serving the community since 1955, our hospital is the preeminent healthcare facility for our district’s nearly 1 million residents.
Antelope Valley Medical Center is a Level II trauma center, Advanced Primary Stroke Receiving Center, STEMI center, Comprehensive Cancer Center, Level IIIB Neonatal Intensive Care Unit, and Baby-Friendly facility. We receive more than 220,000 patient visits each year, deliver 5,000 babies and treat nearly 1,000 trauma patients.
Located just 50 miles north of Los Angeles, the Antelope Valley is one of Southern California’s fastest growing communities. It serves as a significant economic engine in the community with 3,000 employees, 450+ volunteers, and more than 650 physicians on staff who represent 66 different specialties.
Be part of Team AVMC! See current job openings at www.avmc.org/careers