Patient Account Representative, Business Office
Full Time, 80 Hours Per Pay Period, Day Shift
Thompson Cancer Survival Center
Position Summary: The Patient Account Rep II is responsible for inbound inquiries from patients, family members, insurance carriers or other payment sources. The primary responsibility of the Patient Account Rep II is to provide timely and accurate follow-up in response to these inquiries. The Patient Account Rep II will respond to a minimum of 60 inquiries per day or an equivalent work assignment, contingent upon which functional area within the Business Office the position is assigned.
The Patient Account Rep II serves as a resource to Patient Account Rep I’s by providing training and assistance with more complex issues.
There are several sub-categories of the Patient Account Rep II position that are used as internal designations. There may be variations within these designations as to specific responsibilities, related primarily to the customer base being served and the functional area within the Business Office.
- Demonstrates the ability to handle varying tasks as well as understanding and interpreting procedures relative to the Patient Accounts/Customer Service process.
- Demonstrates knowledge of State and Federal regulations, HCFA guidelines, TennCare guidelines and other Third Party Payor requirements assuring departmental compliance.
- Recognizes situations, which necessitate supervision and guidance, seeks appropriate resources.
- Interprets and explains to patients and their families’ charges, services, insurance coverage, and hospital policy regarding payment of their bills.
- Counsels patient or family regarding hospital financial policies including payment arrangements, charity guidelines, and payroll deduction.
- Demonstrates an understanding of payer requirements for all payers.
- Demonstrates an understanding of all patient types with the facilities.
- Serves as a resource for the Patient Account Rep I position by assisting in resolution of complex issues, seeking guidance from appropriate supervisory staff as needed.
- Handles all correspondence relating to assigned patient accounts within five working days of receipt.
- Handles incoming telephone inquiries on assigned patient accounts in compliance with the Covenant Health standards of Telephone Excellence policy.
- Refers patient accounts to nurse auditor upon request by patient or insurance company, and monitors account until completion of audit and follow up is done.
- Performs other duties as assigned to the satisfaction of the department manager.
- Communicates effectively with patients/public, co-workers, physicians and or their offices, and other hospital personnel using verbal, nonverbal and written communication skills.
- Consults and works collaboratively with Supervisors, Co-workers, Managers, Department Director, and other hospital personnel, effectively performing tasks of position.
- Assists Vice President, Director and Managers on activities and projects, as needed.
- Provides assistance and training to new employees.
- Assists with conducting staff meetings.
- Participates freely in intradepartmental quality improvement activities whenever called upon to do so.
- Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
- Demonstrates appropriate utilization of resources, i.e. equipment and supplies.
Minimum Education: None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED.
Minimum Experience: One (1) to two (2) years experience in Patient Accounts/Customer Service is required. Must meet all requirements of Patient Account Rep. I position. Expected to perform adequately within the position after working at least three (3) to six (6) months on the job.
Licensure Requirement: None