Patient Account Representative

Lake Regional Health System is looking for a dedicated, professional Patient Account Representative to join our Patient Financial Services team. With our state-of-the-art hospital and network of clinics, therapy sites, and pharmacies, Lake Regional offers a wide range of employment opportunities in our community.

The Patient Account Representative is responsible for inbound and outbound calls to collect on patient receivables for complete and accurate account resolution. Must be able to work efficiently and in a positive manner in a high-stress, high-call volume atmosphere. This position functions as a team member to organize and prioritize responsibilities to complete daily work requirements.  The ideal candidate will have a positive, supportive, respectful, and helpful attitude in interactions with all department customers (patients, physicians, visitors, and other healthcare team members. This person will maintain a calm, professional manner in all encounters. A high level of attention to detail is necessary for reviewing all work for completeness and accuracy.

Key Responsibilities:

• Ensures all claims are accurately transmitted daily within the PFS targets and goals.
• Provides feedback to management regarding any issues or repetitive errors that may be encountered during claim review and submission.  
• Completes follow-up of claims on a timely basis according to the productivity guidelines for account follow-up goals.
• Reviews system-generated work lists, reports, and/or aged trial balances to resolve accounts that have not been paid in the appropriate time frame, based on specific third-party payor contracts and guidelines.
• Contacts assigned payer representatives to determine when payment will be made and if other information is required to adjudicate a claim.
• Reviews payment denials and discrepancies identified through Explanation of Benefits, Remittance Advice, or payer correspondence and takes appropriate actions to correct these accounts.
• Documents account activities in an accurate and timely manner in accordance with PFS quality standards.
• Applies a high level of knowledge of respective insurance billing regulations and guidelines.  
• Researches these guidelines when required on payer websites where available.
• Ensures compliance with all state and federal billing regulations and reports suspected compliance issues to their respective Leads/Supervisors/Managers.
• Conducts inquiries via telephone, mail, and fax, or electronically through payer websites or e-mail for follow-up of unresolved accounts. Contacts patients for additional information in order to ensure claims are processed and paid.
• Works with various departments throughout Lake Regional Health System in obtaining additional information for the billing and follow-up process.  
• Works with management and PFS staff to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department.
• Maintains proficiency and levels of knowledge with all systems required for task completion.
• Respects the rights and dignity of all patients.  
• Provides and maintains patient privacy at all times.  
• Is compliant with HIPAA guidelines and privacy practices, patient confidentiality, and patient rights.

Must have the following skills:

• Excellent Customer Service
• Excellent verbal & written communication skills
• Proficient in hospital & physician billing
• Proficient in math
• Self-motivated
• Bi-lingual is a plus

Qualifications:

• A high school diploma or GED is required. 
• Previous medical billing experience preferred. 
• Must be organized, customer-focused, and have the ability to multi-task in a fast-paced environment.
• Annual influenza vaccine are required.

Additional certifications may be required for this position and will be coordinated by Lake Regional as a part of your ongoing training and development. Please contact your recruitment team for more details.

Opportunity Features: We offer a competitive compensation package including excellent benefits such as:

• Health, Dental, and Vision insurance
• Supplemental policies to fit your individual needs
• Employer-sponsored life and AD&D insurance 
• Employee Assistance Program (EAP)
• Flexible Spending Accounts
• 401K with a company match
• Paid Time Off (PTO)
• Tuition assistance and continuing education opportunities
• Area discounts
• And so much more!
   

 If you’d like to be a part of a team setting that fosters excellence, apply now!