The Patient Accounts Representative works under the direction of the Patient Accounts Manager; investigates insurance company denials; follows up on delinquent accounts; sends patient statements; handles incoming inquiries regarding claims; prepares monthly reports; maintains accurate, up-to-date patient accounts; verifies insurance; answers the telephone; performs miscellaneous duties as needed.

Responsibilities and Duties

• Works monthly Case Balance Report to follow up on accounts in a timely manner.
• Investigates insurance claim denials and non-payment
  • o Contact and follow up with insurance companies via internet, phone or fax
  • o Compile and submit supporting documentation
  • o Collaborate with therapists regarding diagnosis codes and procedures
  • o Send retro authorizations and/or appeals as needed
• Handles incoming inquiries both in person and over the phone, regarding insurance claims and patient financial responsibility.
• Collects patient payments over the phone and in person. Establish payment plans for outstanding balances and potential deductible responsibility.
• Verifies the accuracy of data entry by reviewing the patient demographic information.
• Requests refunds to patients and/or insurance companies.
• Requests write off of charges that are denied or uncollectible.
• Keeps all correspondence between patient, insurance company, and Concorde Therapy Group accurately documented in patient account.
• Changes patients to “CASH" status once the insurance company has paid their portion.
• Sends patient statements as needed.
• Identifies and collects on all delinquent accounts.
• May verify insurance coverage for physical and occupational therapy using up-to-date procedure codes and ICD-10 diagnosis codes.
• May complete and/or update the insurance coverage section of the Documentation Data Sheet with the patients’ insurance coverage and limitations for the therapists to follow.
• May post daily payments/adjustments and complete the daily deposit summary.
• Performs miscellaneous duties as assigned.

Qualifications

At least a high school diploma and 2 years of billing/collections experience is preferred. Must be able to read and understand insurance remittances.