JOB CODE:		AHS2001
POSITION:		PATIENT ACCOUNT REPRESENTATIVE
LOCATION:		Corporate Office, Laguna Hills, California
STATUS:		Full Time/Hourly
WAGE RATE:		$11.50 - $13.50 (Depending on Experience)

Daily payment posting of client "Batches" which includes, but is not limited to:

1. Daily payment posting of cash receipts; Insurance reimbursements, Patient payments, "Over-the-Counter" payments, etc. Including; appropriate allocation of cash for Doctors, date's of service, payment type, source of funds and procedures.
2. Daily posting of contractual write-offs, co-payments, co-insurance, and deductibles from accurate interpretation of actual Explanation of Benefits.
3. Balance Daily batches. Each batch to be completed reconciled, and summary printed.
4. Identify and forward secondary billing information to Biller. Including photocopying Explanation of Benefits.
5. Identify and resolve any/all Insurance denials. [Medicare denials submitted back to Biller for necessary adjustments].
6. Identify and Re-bill any and all claims paid incorrectly.
7. Identify and log any and all claims which were billed incorrectly. [Back to Biller for appropriate re-billing procedures.
8. Identify patient share balances and balance bill patients as necessary. [appropriate statements, balance bill letter, and deductible letter]
9. Completion and submission of Adjustment/Refund form to Supervisor for approval and processing.

Patient Account Representative functions, which include, but are not limited to:

1. Answer all incoming telephone calls [Transfer/Messages, etc.]
2. Assist Patients via telephone inquiries, including any and all appropriate follow up measures.
3. Account auditing, account resolution and necessary re-billing or re-transmissions of outstanding claims.
4. Insurance/coverage verification, if necessary.
5. Detailed documentation of any and all activity on patient accounts. {In the appropriate notes section.}
6. Informing Management of any and all "unusual" circumstances or occurrences.
7. Weekly correspondence from Insurance Carriers, Patients, and/or Clients.

Client Liaison, which includes, but is not limited to:

1. Assist Clients via telephone/email inquiries, including establishing and maintaining a positive rapport
2. Complete Clients "Daily Balance Sheet" [Faxed back to client each morning]
3. Assist Clients via written correspondence.
4. Document any and all missing procedures or uncooperative behavior.
5. Suggest any change in workflow or use of forms or procedures to Management.
6. Identify and list missing patient information to be requested from Client as needed. {Using template form from Computer}.
7. Informing Management of any and all "unusual" circumstances or occurrences

A/R Management/Follow-up/Collections which includes, but is not limited to:

1. Monthly follow-up of Insurance claims 60+ days or older. [Includes telephone or written inquires to Insurance Carriers, verification of Carrier information, verification of Patient/Insured information], Appeals and Re-billing.
2. Monthly follow-up of Patient Balances 90+ days or older [Includes Statement messages, personal or form letters and telephone calls to patients if necessary]
3. Insurance verification, if necessary.
4. Detailed documentation of any and all activity on patient accounts. {In the appropriate notes section.}
5. Weekly monitoring of "Alert Remarks", and "Call-Backs" [Tickler system].
6. Establishing and monitoring of "Payment Plan" patients.
7. Informing Management of any and all "unusual" circumstances or occurrences.
8. Any and all correspondence to Patients, Insurance Carriers and Third-parties, [Must be approved by Management within 90 day probation period]
9. Account auditing, re-bills, and account resolution.
10. Develop and maintain personal organization and follow-up procedures.

General Responsibilities, which includes, but is not, limited to:

1. Manage personal voice mail, including; responding to Patient and Client messages and inquiries.
2. Assist with retrieving voice mail messages if necessary.
3. Participate in daily "Shared Office Duties". (Per schedule)
4. Coordinate courier schedule for Client pick-up and drop-off.
5. Maintain a professional, positive and "team-effort" oriented attitude.
6. Maintain personal work area, to be organized and professional.
7. Computer proficient, including, Windows, Word, Excel, and e-mail.
8. Any and all duties and/or projects called upon by Management as necessary, related or un-related to your job description.

All responsibilities are subject to change or modification as deemed necessary by the management.


To apply for this position: (PLEASE REFERENCE JOB CODE AND DESCRIPTION)

Please email your resume with cover letter and salary history to: jobs

Or

Send a copy of your resume with cover letter and salary history to:

Advanced Healthcare Solutions, Inc.
Human Resources Department
23010 Lake Forest Drive #D
PMB410
Laguna Hills, CA 92653

Or:

Fax a copy of your resume with cover letter and salary history to:

** Please be advised that due to the volume of resumes received, only potential candidates will be contacted for interview scheduling **