Job Description

Position Summary: The Patient Account Representative (PAR) bills various insurance carriers, including governmental agencies.  Incumbent provides effective and personalized patient account services on all accounts within their assigned range.  Incumbent performs a variety of collection, patient account follow-up, and maintenance functions in order to maximize cash flow and acts as a resource person to customers. Work schedule is 8:00am - 5:00pm PST M-F, with a 30-minute lunch break.

Reporting Relationships: The PAR reports to the Business Servies Manager; the Business Services Manager report the Chief Financial Officer.

Principal Accountabilities:

  1. Submits accurate and timely claims to all fiscal intermediaries, third party payers and patients.
  2. Provides timely and effective follow up and collection on all unpaid claims.
  3. Acts effectively as a resource for patients, attorneys, third parties, and co-workers.
  4. Keeps accurate records and performs patient account maintenance.
  5. Any additional duties may be assigned.
  6. Must be able to understand and comply with Eastern Plumas Health Care policies and procedures.
  7. Must be able to maintain patient confidentiality and comply with all regulations as set forth in the Health Insurance Portability and Accountability Act of 1996 (HIPPA)

Position Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are a representative of the knowledge, skills, and abilities required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience: The following education or combination of education and experience are required for the position:

  1. High School diploma or equivalent
  2. Additional education in a healthcare related field, or experience in medical billing is preferred.
  3. Basic office procedures, knowledge of CA billing and collections rules and regulations are required.
  4. Medical terminology is desired.
  5. Ability to accurately perform basic math.

Skills: 

  1. Excellent written and oral communication skills
  2. Ability to analyze data, perform multiple tasks, and work independently.
  3. Must be able to prioritize tasks and exhibit excellent time management.
  4. Accurate filing, typing 35 wpm, computer literacy and 10 key calculators.

Physical Capacities/Equipment Operated:

  1. Ability to perform repetitive motions with fingers, hand, arms, neck, and shoulders.
  2. Ability to bend, stoop, reach, and sit for extended periods of time.

Working Relationships:  The incumbent works closely with the Business Services Supervisor and Manager and has routine contact with other hospital staff, physicians, physicians' office staff, state health entities and third party payers.

Freedom to Act/Accountability:  The incumbent has full authority to monitor billing/payments and accurately change billing codes or methods to optimize reimbursement and expedite payments.  The incumbent has the authority to negotiate payment plans with the patient not to exceed EPHC policy.  The incumbent has the authority to determine what action is needed to expeditiously and effectively process individual patient accounts related matters and only seek assistance or approval when he/she determines is necessary.  The incumbent has full authority to update various patient related data.  The incumbent refers to the Manager and Supervisor accounts that require refunds, collection agency assignment, and administrative adjustments. 

Privacy and Confidentiality:  As set forth in the Health Insurance Portability and Accountability Act of 1996 (HIPAA), this position must maintain patient confidentiality in accordance with State and Federal regulations. Protected Health Information is restricted to a need-to-know basis. Any intentional or unintentional breach of confidentiality will be reported to the HIPAA Privacy Officer and is subject to disciplinary action, up to and including termination of employment.