Patient Account Representative Resume Examples

Patient Account Representative

Managed Account Receivables for 40+ providers

• Maintained accurate and timely collections of balances to ensure a balanced deposit each day
• Communicated with patients, faculty, students, insurance companies and other departments to resolve patient accounts
• Resolved system reports such as aged accounts receivable and unallocated payments reports
• Answered patient questions, inquires and concerns regarding their accounts
• Trained new employees on all aspects of Patient Account Representative responsibilities

Patient Account Representative

Maintained all patient account balances within required time frame

• Monitored all delinquent accounts and managed collection activities
• Assisted to resolve billing issues for customers through regular inquiries
• Performed medical collection activities as per established guidelines
• Ensured compliance to HIPPA laws and federal regulations
• Administered credit balances for all patients and players
• Coordinated with customers to answer patient payment plans

Patient Account Representative

• Billed and collected Medi-Cal claims on UB92; contacted Insurance payers to facilitate efficient cash collections; appeals and follow up on all outstanding revenue over 45 days; reconciled accounts using EOB's and processed adjustments when needed.
• Reduced aged A/R under 120 days in 3 months
• Increased Medi-Cal revenue by 40 % in 3 months
• Selected as staff trainer for Premis

Patient Account Representative

Using a telephone, collected payment from delinquent medical self-pay accounts.

• Arranged for payments to be made by debtors via telephone, sending statements to debtors, insurance companies, and attorneys in accordance with established policies and procedures.
• Worked with third party payers to ensure timely recovery of outstanding delinquent accounts.
• Following Federal and State regulations in a manner that ensured positive patient and client relations.
• Prepared and distributed patient billings on a weekly basis.
• Analyzed and discussed disputed patient accounts with senior management.

Patient Account Representative

Rebilled claims to either primary or secondary insurance companies.

• Appealed when necessary for underpayment and/or no pre-certificates and authorizations.
• Completed all related requests and correspondences from insurance companies.
• Assisted Self Pay team members in resolving patient's account balances.
• Researched and responded to all insurance inquiries received by telephone, fax and mail.
• Updated patient's insurance information and initiated account adjustments.
• Metrix, Epremis (Relay Health), Paragon, Med Assets (Contract Manager).

Patient Account Representative II

Resolved complex patient account issues.

• Collect and follow up on all accounts assigned prior to, during, or after admission and discharge. Communicated financial policies to all patients.
• Verified, researched, and completed all paperwork to billed Medicare and Medicaid claims for reimbursement.
• Served as patient advocate during the entire cycle of the account through telephone, mail, and research efforts. Medicare Collector/Billing.
• Working reports for Credit balances, refunds, bad debt, and IME billing. Re-billed Inpatient/Outpatient claims, updated insurance information.
• Work (RTP) Return to provider claims and issues using resources and DDE/FSS Medicare/Medicaid GAMMIS system.

Patient Account Representative

Responsible for reviewing commercial and government insurance payments on hospital inpatient/outpatient (UB04) and professional fee (CMS 1500) claims utilizing Meditech software.

• Contact commercial and government payers regarding underpaid and denied claims as well as contacting patients regarding claim issues.
• Handle correspondence from insurance companies regarding billing questions, billing issues, and medical claim denials. Identify and correct any coordination of benefit problems identified on patient accounts.
• Process refund requests for insurance overpayments and patient overpayments and confirm claim underpayments/overpayments by analyzing the insurance explanation of payments and insurance contracts.
• Identify authorization, cash posting, and registration errors on patient accounts and route to the appropriate department for correction.
• Submit unbilled or corrected UB04 and CMS 1500 claims by utilizing Quadax/Xpeditor software.

Patient Account Representative

• Performed and facilitated claims processing with third party payors for coordination of benefits.
• Managed claim denials by contacting clinical department, patient, payor or fiscal intermediary by phone, email or appropriate website
• Initiated appeals on denied hospital claims requiring detailed research for claim resolution
• Communicated to and advised appropriate staff of changing payor policies, denial trends and policies
• Maintained patient accounting files requiring detailed notes, manual logs and on-line functions for submission to third party payors
• Assisted with claim edits.

Patient Account Representative

Mastered cardiology billing rules and utilized this knowledge to work aging accounts. Promoted to Medicare Team Leader position and was responsible for a team of four employees. Trained current staff and new hires in effectively working Medicare claims in this specialty.

• Followed up on unpaid claims for all insurance types.
• Set up patient accounts/encounter visits and entered charges for billing.
• Answered patient billing questions and addressed patient complaints.

Patient Account Representative

Managed electronic records, indexed, and managed workflow using BAR and LSS Document Management Systems.

• Facilitated release of information (ROI) and medical records requests to all Centura hospitals for fulfillment.
• Data entry to include attaching all electronic correspondence to patient accounts and notating accounts for further processing within internal Centura departments.
• Documented CHPG databases and Retail Lock Box queues when needed.
• Used knowledge of true technical denials, coordinated EOB's.