Pioneer Medical Center is interviewing for a full-time role as a "Patient Account Representative I or II", working primarily in an office environment, this person enters billing information, answers patient questions about billing, and does some calling to follow up on billing.
This is a good opportunity for someone to break into healthcare, learning billing, record keeping and medical terminology on the job.
This person also shares coverage of the main switchboard for break and absence events.
No direct experience is necessary, but you should have had some success in a previous role (work, community or school activity, etc.) demonstrating that you work cooperatively in a sometimes high-speed environment, enjoy providing good service to others, can juggle multiple simultaneous activities, never hear yourself thinking 'that's not my job', can consistently be patient and caring with others, are a self-starter, and organized.
Exemplary attendance, good hearing, speaking and writing/data entry skills are musts.
Pre-hire drug & TB testing, plus some immunizations required. Surgical masks, safety glasses, daily temperature checks and weekly COVID testing required. No waivers given. COVID & flu immunizations available, but not required, for all employees.
Pioneer Medical Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, pregnancy, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
The Job Description:
1. Supports and practices the mission and philosophy of PMC.
2. Downloads remittance advices from electronic fund transfers for EBO to post payments from. Tracks credit card payments and reconciles with bank statement.
3. Posts patient (limited) and miscellaneous payments. Tracks miscellaneous payments for cost reporting purposes. Prepares bank deposits.
4. Enters charges as necessary. Verifies accuracy of entry with batch reports. Verifies workers’ comp information as needed and sends billing information to carrier.
5. Verifies insurance eligibility as necessary. Update accounts as needed.
6. Researches and follows up with insurance carriers on denials, rebills as appropriate.
7. Monthly billing for long term care and assisted living residents.
8. Manage trust fund account for long term care residents.
9. Performs collection duties as assigned. May include calling patients, setting up payment plans and sending accounts to a third party for self-pay management and collection.
10. Responds to inquiries from external and internal customers regarding insurance coverage issues, coordination of benefits and general billing questions.
11. Obtains pre-authorizations as needed.
12. Applies overpayments and issues refunds as appropriate.
13. Bills for visiting specialists and school therapy services.
14. Assists with administrative filing and scanning of invoices and receipts. May assist with QC for medical records department.
15. Maintains competency in all organizational, departmental and outside agency safety standards relevant to job performance. Performs safety and infection control procedures to ensure a safe and clean environment. Reports any and all conditions that may interfere with the safety and well- being of staff, residents, patients and others on the PMC campus.
16. Identifies needs and sets goals for own growth and development; meets all mandatory system/departmental requirements.
17. Uses performance improvement principles to assess and improve quality.
18. Performs other duties as assigned or needed to meet the needs of the department/organization.
KNOWLEDGE, SKILLS AND ABILITIES
• PMC policies and procedures, both organizational and departmental
• Confidentiality principles
• Principles and practices of customer respect and service
• Principles and practices of effective teamwork, and of being a fully contributing member of an effective organization
• Principles and practices of respectful and effective communication, in writing, over the telephone and in face-to-face encounters.
• Incorporate age and culturally appropriate considerations into all aspects of communication and patient care. Note that the scope of services PMC provides will encompass age groups from infant through geriatric
• Communicate clearly and effectively, both verbally and in writing
• Establish and maintain collaborative relationships
• Remain calm and professional in working with challenging people and in emergent situations
• Do consistently accurate work, including in daily duties that require exacting attention to detail
• Handle multiple tasks at one time, setting appropriate priorities in self-scheduling
• Expect and work effectively with change
COMPLEXITY & DIFFICULTY:
Data collection and entry errors can result in incorrect identification of the patient, guarantor and financial information necessary to facilitate billing and collection procedures, resulting in loss of reimbursement to PMC, and patient financial & satisfaction issues.
This position involves extensive clerical duties.
This Position requires the highest degree of integrity and confidentiality due to the sensitive nature of information handled. Failure to maintain patient confidentiality could result in legal action, disciplinary action and patient satisfaction problems.
The major challenges of this position are to complete all functions of the job in an accurate, timely and efficient manner, provide an attentive, warm and welcoming atmosphere to all residents, staff, and visitors.
This position requires the ability to maintain professional and open communications with all parties during both calm and difficult or emergent situations.
· High school graduate or equivalent required
· Medical environment experience preferred
· Experience with and strong working knowledge of MS Word, Excel and Office Suite
Normal office environment. May be required to work varying shifts, and occasional weekends or holidays.
Category III: Tasks that involve occasional exposure to blood, body fluids or tissue, and Category I tasks are not a condition of employment.