Employment Status:Full Time (72-80 Hours Per Pay Period)Job Category:Administrative & ProfessionalJOB SUMMARY:Under supervision, the Patient Accounts Representative will be responsible for functions related to insurance verification and quality control, including providing clerical support to operate effectively.
This position will verify third party coverage and benefits and review patient accounts to ensure data is complete and accurate.
The Patient Accounts Representative will also be responsible to assume the duties of the Business Office Cashier such as, but not limited to, cash collection, payment posting and assisting customers.EXPERIENCE/QUALIFICATIONS:Previous healthcare setting customer service experience highly desiredExcellent customer skills and effective communication skills (written and verbal)Detailed-orientatedProficiently use and knowledge of PC and 10 KeyBilingual in English and Spanish preferredEDUCATION:High schools diploma or equivalent educationLICENSURES/CERTIFICATION:Must successfully complete and maintain LA City Fire Card certification at the time of hire or within the first 30 days of employmentDUTIES AND RESPONSIBILITIES ( These are the essential job functions for this position.
The essential functions of this job include, but may not be limited to those listed in this job description.
Employees hired for this position must be able to perform the essential function of this job without imposing significant risk of substantial harm to the health or safety of themselves or others) :Performs cashier duties involving settlement of patient accounts including related clerical activity such as auditing charges, issuing receipts and preparing bank deposits.Collects cash in person, issues receipts and balances daily cash drawer.Receives, process, and post payments from patients (including mail payments) for charges, handles any routine questions concerning billing, charges or insurance coverage.Maintains a high degree of accuracy in all areas of work responsibility, including posting and calculations of patient liabilities.Explain financial and hospital policies and procedures to patients’ satisfaction and understanding.Locks up and retrieves patient’s valuables.Verifies and performs quality control on accounts.Maintains records of insurance Carrier addresses for HMO & Crossovers.
Bills Crossovers timely and accurately.Verifies third party coverage/benefits providing interpretation of benefitsUtilizes payer matrix for services verses payer responsibility, notifies Lead of changes relating to insurance matrix.Demonstrates knowledge of policies and regulations relating to changes in the authorization process.Deletes ‘wrong’ plan with-in timely time-frame.Request Medical Records as requested from the insurance companies.
Monitors and follows-up on Medical Records request for timely requirements.Enters and processes all correspondence relating to patient accounts according to in-depth policy procedure guidelines.Maintains phone logs, plan change log, medical records prior to 07/15.Documents Biller rejections for MDX and Emdeon electronic billing and follows-up on the request.Responsible for scheduling Vendors, updating QQSR and KPI cash graft, order and maintain PFS supplies and all PFS forms, retrieves PFS mail from mail room.Assist with the account research, documents and completes assigned accounts in a timely manner.Performs general filing and ensure it is maintained accurately.Performs other duties as assigned.The following job accountabilities are not unique to this particular job but are common to all jobs at VPH:Complies with VPH policies and procedures on customer satisfaction and service excellence.
Demonstrates professionalism and cultural sensitivity in coordinating activities and communicating with all customers, peers, and the community at large.
Conducts self in a professional, respectful and courteous manner during all interactions.
Works effectively and collaboratively with others toward common goals.Communicates accurately, honestly, supportively and in a timely manner with department and interdepartmental team members.
Demonstrates effective business writing and oral communication skills, handwriting is clear and legible.Participates in operational aspects of the department, and maintains/participates in performance improvement activities within the department.Participates in all departmental specific training, Environment of Care (injury/illness prevention, fire/life safety, hazardous materials, emergency preparedness, utilities management, medical equipment management, safety and security management), infection control (standard precautions, TB Exposure Control Plan, Bloodborne Pathogen Exposure Control Plan).Demonstrates knowledge of and follows safety practices.
Understands the importance of safety, including patient safety in the work place.
Maintains a safe environment for self and others.Actively participates in the Patient Safety Program, including event reporting.
Identifies sentinel events/near misses and responds per defined organization processes.
Participates in education activities and process implementation.
Demonstrates advocacy for the patient/customer and appropriately acknowledges patients, customers and visitors.The above statements reflect the essential functions considered necessary to describe the principle content of the job.
They are not intended to be a complete statement of all work requirements or duties that may be inherent in the job.WORK ENVIRONMENT: Primarily an inside building/office environment, well lighted and ventilated, which may consist of multiple treatment and/or work sites.
Fast and continuous work pace with variable workload.
Frequent contact with staff and public under a variety of circumstances.
Requires ability to communicate clearly (in English) verbally and in writing for effective communication with other staff members, physicians, vendors, community members, patients and patient families, employees and applicants of all socio-economic levels from a diverse cultural and ethnic population.
Subject to many interruptions from multiple calls and inquiries and potentially emotional situations involving accidents, injuries, illness and/or death.
Handles emergency/crisis situations in accordance with Hospital policy.
Answers phones or pages; may carry a beeper/pager, and/or use a two-way radio.
Occasional travel may be required.
Potential risk of exposure to hazards from chemicals (toxic and non-toxic), flammable materials, gas or electrical or radiant energy or equipment with/without moving parts.PHYSICAL DEMANDS: Key for Physical DemandsContinuous66 to 100% of the timeFrequent33 to 65% of the timeOccasional0 to 32% of the time Patient Care Continuous standing/walking and occasional/intermittent sitting.
Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and shoulder level to handle/operate medical equipment/devices.
Frequent reaching above shoulder level and overhead.
Frequent forward bending, twisting, squatting and kneeling; occasional climbing.
Occasional repositioning and transferring patients weighing up to 200 pounds between bed, chair, and gurney.
Occasional lifting and carrying equipment weighing up to 25 pounds.
Occasional/intermittent pushing of gurneys, wheelchairs, bed and other medical equipment over tiled and carpeted surfaces.
Continuous use of near vision to read medical equipment such as monitoring devices and reading documents and computer screens; hearing and verbal communication to interact with patients, co-workers, and other customers.
Clerical/Administrative Patient Care Frequent sitting and standing/walking with frequent position change.
Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.
Occasional/intermittent reaching at or above shoulder level.
Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting, and climbing.
Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.
Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.
Clerical/Administrative Non-Patient Care Frequent/continuous sitting with occasional, intermittent standing/walking.
Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.
Occasional/intermittent reaching at or above shoulder level.
Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting and climbing.
Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.
Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.