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PATIENT ACCOUNT REPRESENTATIVE

Job Details

Hawarden Regional Healthcare - Hospital - Hawarden, IA
Full Time

Description

GENERAL SUMMARY:

Under general direction, assumes the responsibility for ensuring that all billing, collection, and follow up on patient accounts including patient calls, visits and inquiries from third party payers is completed in a timely manner. Adheres to the mission, values and standards of excellence of Hawarden Regional Healthcare in all aspects of job performance.

 

 

ESSENTIAL JOB FUNCTIONAL COMPETENCIES:

Competent

Opportunity to Improve

1.

Demonstrates the knowledge and skills necessary to provide service/care appropriate to the age of the patients served, in accordance with Hawarden Regional Healthcare standards. Maintains a working knowledge of applicable Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, and HRH policies and procedures, including all provisions of the Health Insurance Portability Act of 1996 (HIPAA). In order to ensure adherence in a manner that reflects honest, ethical and professional behavior by implementing the organizational vision, values, and mission.

 

 

2.

Assists in developing and implementing goals and objectives for the department.

 

 

3.

Maintains state of the art technical skills by reviewing literature and professional journals, attending seminars and workshops, and daily contacts with peers.

 

 

4.

Provide cost estimates and communicate pre-service patient liability based on expected charges and potential coverage, as requested.

 

 

5.

Coordinate refiling of insurance claims for all insurance companies for all charges. Track, review and correct any rejected claims.

 

 

6.

Assist in preparation of daily clinic deposit and reconciliation when needed to fill in.

 

 

7.

Is responsible for keeping current with updates related to the computer system from hardware and software vendors.

 

 

8.

Responsible for answering incoming calls to the Business office and help them with their various needs.

 

 

9.

Greet visitors in the Business Office and help them with their various needs.

 

 

10.

Responsible for all record keeping for all patient account information for the Business Office. Responsible for typing messages on all patients’ accounts as needed. Responsible for the collection of self-pay accounts.

 

 

11.

Responsible for updating and working aging accounts to ensure proper and timely reimbursement to avoid denials and timely filing of claims.

 

 

12.

Maintains continual updates on insurance information for all carriers as related from management and billing office, collaborating with appropriated billing staff personnel to facilitate the update of various files for all types of carriers.

 

 

13.

Recognizes and communicates issues/occurrences utilizing established lines of authority, and assists in identifying ways to resolve variances or unacceptable outcomes.

 

 

14.

Demonstrates general working knowledge of computers and department specific software (i.e. Healthstream, internet, etc.)

 

 

15.

Actively participates in departmental meetings, committees, conferences, and in services. Is knowledgeable of and complies with Safety and Infection Control Policies & Procedures. Participates in Continuous Quality Improvement activities as requested. Keeps up to date on new procedures and research. Maintains confidentiality of information pertaining to clients, physicians, employees and HRH business.

 

 

16.

Completes all mandatory training such as Healthstream, The Patient Experience, Safe Choices, Crucial Conversations and any other training as designated by Administration.

 

 

17.

Performs other duties and responsibilities as assigned.

 

 

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.

 

 

MISSION STATEMENT

Provide for the health and wellness of all in our communities through delivery of quality healthcare services close to home.

STANDARDS OF EXCELLENCE

The standards of excellence are the behaviors necessary for all of us to achieve our Vision. They are:

  • Trust – Being a reliable resource for patients, families and co-workers by acting with honesty and integrity at all times.
  • Caring – Displaying kindness and concern for others by creating a welcoming environment for all those who enter our facility.
  • Communication – Giving and receiving information that others need or desire.
  • Pride – Fulfillment of being a part of something bigger than yourself.
  • Accountability – Taking responsibility for my actions and decisions.
  • Respect – Honoring our patients, families and co-workers.

 

COMMITMENT

Must be able to embrace and adhere to the standards of excellence of the organization and support the Mission of Hawarden Regional Healthcare.

 

Must demonstrate good work habits such as time management, attendance, punctuality, team building and other behaviors aligned to the mission and values of the organization.

Qualifications

  1. High school education or equivalent required. Two years of additional education preferred.
  2. Previous experience in health care with emphasis in the area of patient accounts billing and collections preferred.
  3. Excellent communication (oral and written) and people skills.  Ability to deal effectively with a diverse range of persons.
  4. Is able to perform a variety of duties characterized by frequent change.
  5. May be requested to travel within the region.  When assigned to travel, a valid driver’s license and proof of insurance will be submitted to manager prior to travel.
  6. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of Hawarden Regional Healthcare.

 

 

Hawarden Regional Healthcare cultivates, upholds and supports a safe work environment. Employees support patient and staff safety by demonstrating aptitude and maintaining organizational employment standards and requirements. Employee job performance is continually appraised and formally evaluated during the course of employment with Hawarden Regional Healthcare.

 

PHYSICAL REQUIREMENTS:

  1. Must successfully pass pre-employment physical examination, drug screening, and must adhere to applicable organizational requirements on an annual basis for Employee Health Directives.
  2. Must possess the ability to comply with Hawarden Regional Healthcare policies and procedures.
  3. Will need to handle, turn, lift or lower objects usually 25 lbs. Or less with the hand or hands.  Walking, standing, bending, stooping, ascending and descending stairs, and sitting for extended periods of time will be necessary.
  4. Able to perform effectively under stressful situations.
  5. Must understand and accept the possibility of exposure to environmental elements, such as exposure to noise, chemical and/or chemical fumes, and infectious disease.
  6. Regular and physical attendance at work is an essential function of the job.

 

These essential functions identify the major requirements of the job.  They are not an exhaustive list of all job requirements.  An employee may be called upon to perform physical actions not specifically identified in this job description.

 

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