Job Description

Description

Eastern Plumas Health Care is a small, non-profit, critical access hospital district, providing comprehensive medical services to Plumas County since 1971. We operate a 9 bed acute care hospital at our main Portola campus, which includes a 24 hour, physician staffed, emergency room and ambulance service. In addition, four primary care medical clinics and a dental clinic offer residents a full spectrum of health care services in the Graeagle, Loyalton, and Portola communities. There are also hospital-based Skilled Nursing Facilities in Portola and Loyalton.

POSITION SUMMARY:

The (PAR) Patient Accounting Representative is responsible for their daily billing and collection tasks as well as assisting and supporting other billing and collections staff in the EPHC business services office in the performance of daily operations.  The PAR assists and supports staff through an understanding of billing and collections software and procedures, Commercial Insurance, DHS, Medi-Cal, Medicare, CHDP, HCFA regulations, customer service standards and systems. Assists and back up of other staffing functions. 

 

PRINCIPAL RESPONSIBILITIES:

  • Ensures all claim submissions within their assigned billing alpha as well as their lead areas are accurate and timely. 
  • Will work closely with data processing, financial systems analyst, cash applications and information technologies, health information, coding and all departments in the revenue stream, on process and compliance to ensure services are tracked from encounter to adjudication 
  • Tracks data in the healthcare EMR and the claims remittance management system (ePremis) daily.  The incumbent will monitor data flow from HIM, coding and all charge entry for errors and inconsistencies.  Will review days from admission to coding, insurance date etc.  Complete the bill runs daily prior to 11:00am.  Review billing activity for too high, low or zero charge claims.  Will report to the Billing services Manager/Supervisor all errors, problems and billing/collection issues. 
  • Ensures and monitors timely and effective follow up and collections on all unpaid claims in their assigned range. 
  • Acts effectively as a resource for biller/collectors, patients, attorneys, and third parties. 
  • Keeps accurate records and performs patient account maintenance as needed. 
  • Coordinates, maintains, and oversees projects as assigned by the Business Services manager or Supervisor. 
  • Updates staff members with related bulletins, updates and new rules or regulations. 
  • Cooperates with other departments to facilitate in-service and training opportunities. 
  • Any additional duties that may be assigned. 
  • Must be able to understand and comply with Eastern Plumas Health Care policies and procedures. 
  • 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 representative of the knowledge, skills and abilities required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Basic office procedures, knowledge of state and federal billing and collections rules and regulations are required.  Ability to compile and analyze data.  Basic mathematics and accounting.  Excel spreadsheets and Word.

 

EDUCATION/EXPERIENCE:

Typically requires a High school diploma or equivalent. 

 

Experience:

Additional education or experience in a hospital environment or medical billing office is required.  A 3-5 year combination of education and experience which leads to the possession of the requisite skills and abilities will be considered

 

PHYSICAL CAPACITIES/EQUIPMENT OPERATED:

Ability to perform repetitive motions with fingers, hands, arms, neck and shoulders.  This position includes bending, reaching, squatting and extended periods of sitting.