Patient Account Rep

Patient Account Rep 3.0 3.0 out of 5 stars Winter Haven, FL 33880 Central Florida Health Care, Inc. 2 reviews

Title:

Managed Care Patient Account Representative Reports to:

Director of Managed Care FLSA Status:

Non-Exempt Personnel Supervised:

None

POSITION SUMMARY

MINIMAL

QUALIFICATIONS

Minimum of 1-3 years healthcare experience working in a managed care, revenue cycle or billing office setting Knowledge of medical terminology or concepts is a must Proficiency in Microsoft Office applications including Word, Power Point, Excel, and Outlook is a must. High school graduate or equivalent required.

KNOWLEDGE AND SKILLS

Electronic Health Records Knowledge of billing practices and billing office functions required, FQHC preferred Knowledge of medical records, E H R required Must have good math skills and effective communication skills Must have good problem-solving skills

RESPONSIBILTIES AND PERFORMANCE EXPECTATIONS

include, but are not limited to, the following: Be familiar with CFHC's program philosophies, goals and objectives. Be cognizant of and comply with all CFHC's policies and procedures, as well as state and federal regulations. Be competent in performing the duties of a referral specialist. Report as needed to CMO any pertinent information or situations that impact on patient care or CFHC liability. Attend and participate in mandatory CFHC meetings (Center Specific meetings, Corporate meetings, and other meetings as designated by the CMO or CEO). Demonstrate ability to work cooperatively with other members of the clinical team. Be supportive of coworkers. Maintain a neat and professional appearance at all times. Carry out any other activities deemed appropriate by the CMO or CEO. Coordinate all aspects of completing referrals ordered by CFHC providers Complete referrals in a timely manner; STAT referrals must be completed by end of business day, URGENT referrals within 24 hours, and ROUTINE referrals within 72 hours Obtain appropriate authorizations from insurance companies sending necessary documentation from the patient's medical record as required Schedule referral appointments for patient (when applicable) ensuring proper paperwork is faxed to the specialist or given to the patient to take to the appointment (example, labs, x-ray reports, progress notes) Notify patient of scheduled referral appointment Document appropriately and thoroughly Track all referrals accordingly to improve the quality and continuity of care provided to patients. This includes, but is not limited to, initiating reminder calls to patients prior to their scheduled appointment and obtaining the referral report from the specialist. Notify the ordering provider and/or Referral Specialist Supervisor of any problems in obtaining a patient's referral, including issues with obtaining authorizations from third party payors or making appointments with a specialist, patient refusal of a referral, or patient no show to scheduled referral appointment Maintain specialty provider list including payor sources they accept Review referral log weekly to ensure completion of all referrals Other duties as assigned by Referral Specialist Supervisor

PHYSICAL REQUIREMENTS

Requires 80% or more time spent sedentary. Independently mobile. Ability to lift weight equivalents that would be required with repositioning equipment and lifting supplies. Ability to adapt and function in varying environments of workload, patient acuity, worksites, and work shifts. Occasional travel required American with Disabilities Act (ADA)

Statement:

External and internal applicants, as well as position incumbents who become disabled, must be able to perform the essential job specific functions (listed within each job responsibility) either unaided or with the assistance of a reasonable accommodation to be determined by the organization on a case by case basis.