GW Medical Faculty Associates—Patient Account Representative


Requisition Number 16-0090
Post Date 3/1/2016
Title Patient Account Representative II – Business Office
City Arlington
State VA
Department Business Office
Description Position Summary:
Responsible for the billing, collection, and resolution of patient account balances to include the development of action plans to resolve delinquent accounts and respond to complaints.

Essential Duties and Responsibilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.

1. Reviews and interprets payer remittances to determine appropriate action to be taken on denied claims. Based on basic proficiency in diagnosis coding (ICD-9) and procedural coding (CPT) may resubmit for coding correction.
2. Contacts payers for status of unpaid claims. Maintains knowledge/understanding of third party payer regulations for managed care, Medicare, and Medicaid accounts.
3. Resubmits claims to payer, if no record of receipt.
4. Corrects and/or updates patient registration data. Reviews all invoices and makes necessary financial transfers.
5. Analyzes outstanding account balances and determines plan of action to resolve.
6. Appeals low payment claims to maximize reimbursement.
7. Communicates payer trends or problems, identified as impacting reimbursement, to management team.
8. Respond to billing inquires. Researches and effectively resolves issues through knowledge of medical billing practices. Documents actions taken and communicates results.
9. Recommends account adjustments for bad debt write-off, contractual allowances, and discounts.
10. Initiates collection calls to patients for outstanding balances.
11. Generates collection letter and follows up on delinquent account balances. Maintains knowledge of consumer credit regulations for self-pay accounts.
12. Makes payment plan arrangements for patients experiencing financial difficulty.
13. Arranges settlement of accounts with attorneys and insurance companies.
14. Organizes daily time to meet collection goals and productivity standards as defined by the management team.

Requirements Qualifications:
The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

A High school degree is necessary. An Associate’s degree in accounting, business or health care administration is desirable.

A minimum of 3 years experience as a patient account representative, or an equivalent combination of experience and education, is necessary. Familiarity with computer terminal and current office equipment is necessary. Training or experience with coding and payer regulations is necessary.

Supervision Received:
Functional supervision is received from the Credit & Collections Manager. Administrative supervision is received from the management team to include guidance on collection goals or special projects.

Supervision Exercised:
Functional supervision may be exercised over clerical staff or as a work leader for special projects.

Equipment To Be Used:
Must be able to operate computer and other office machines such as fax, calculator, telephone and so on.

Typical Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Frequent mobility and/or sitting required for extended periods of time. Requires manual dexterity to operate computer keyboard, calculator, copier machine, and other equipment.

Typical Mental Demands:
Must have excellent verbal and written communication skills. Must be able to communicate providing verbal feedback in a professional manner. Must be able to follow and understand instructions, and react favorably in all work situations. Must have strong interpersonal skills and be mentally adaptable and flexible in dealing with a variety of people at various levels within and outside the MFA.

Working Conditions:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Works in a typical office setting.


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