Patient Account Rep Resume Sample
Garnet Abbott
32768 Smitham Flat,
Houston,
TX
+1 (555) 723 0119
Work Experience
Senior Patient Account Rep
07/2015
-
PRESENT
Phoenix, AZ
- Acknowledges patient’s rights on confidentiality issues, maintains patient confidentiality at all times, and follows HIPAA guidelines and regulations
- Responsible for reviewing accounts for correct third party billing as assigned
- Contacts insurance carriers, patients, and clinics to resolve claim issues
- Updates patient registration and insurance as needed to correctly file claims
- Files claims according to insurance company guidelines
- Demonstrates a knowledge of CPT, ICD-9 coding and their requirements for specific insurance carriers
- Participates in recognizing denial trends and provides feedback to manager
- Maintains claim and online notes
Patient Account Rep
01/2012
-
05/2015
Philadelphia, PA
- Responsible for keeping current with federal and state compliance and insurance industry regulations
- Maintains knowledge of confidentiality laws
- Maintains knowledge of third party liability laws
- Understand and utilize a complex high sophisticated billing system
- Comprehend complex insurance claims for a multi-faceted healthcare facility
- Maintains competent job performance or better, despite large workload
- Communicates with customers and peers in a positive manner
- Promotes the Spirit of Mercy at all times
- Office/Team Work Environment
Patient Account Rep-patient Financial Services
08/2006
-
12/2011
Chicago, IL
- Answers patient’s questions regarding statements, agency coverage, etc
- Assists in reviewing and balancing IDX transaction reports for administration
- Reconciles daily IDX receivables reports
- Prepares billing statements from statistical data
- Credit balance resolution
- Review daily billing and accounts receivable credit balance reports
- Prepare daily refund check requests
Education
Indiana Wesleyan University - Kokomo Campus
2001 - 2006
School's Degree in Computer
Professional Skills
- Medical office billing experience, PC skills, excellent customer service skills, analytical abilities, excellent attendance
- Computer experience, strong customer service skills
- Demonstrated critical thinking and reasoning skills
- Excellent computer skills (including Microsoft Excel)
- Demonstrated effective communication and interpersonal relation skills
- Good interpersonal skills with ability to work effectively with all levels of Clinic staff, vendors and patients
- Excellent organization and time management skills with ability to meet deadlines and achieve results
How to write Patient Account Rep Resume
Patient Account Rep role is responsible for customer, computer, medical, typing, organizational, software, interpersonal, microsoft, finance, credit.
To write great resume for patient account rep job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Patient Account Rep Resume
The section contact information is important in your patient account rep resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Patient Account Rep Resume
The section work experience is an essential part of your patient account rep resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous patient account rep responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular patient account rep position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Patient Account Rep resume experience can include:
- Strong knowledge of PC Accounting Software functions and Microsoft Applications
- Following up directly with payors regarding claims processing/payments
- Communicating as a customer service/billing representative to patients to resolve billing questions
- Working of various billing queues to resolve denials, demographic errors and other holds
- Tracking of billing errors and their sources to ensure process improvement
- Verifying insurance benefits when necessary for accurate claims processing
Education on a Patient Account Rep Resume
Make sure to make education a priority on your patient account rep resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your patient account rep experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Patient Account Rep Resume
When listing skills on your patient account rep resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical patient account rep skills:
- Proficient skills in data entry, medical account reconciliation, and charge entries appropriate to level of experience
- Good communication skills, proficient in Microsoft Office
- Demonstrated computer experience using word processing and data entry software
- Healthcare/collection experience and or equivalent experience in a hospital setting
- Professional and responsive customer service skills
- Organizational skills, attention to detail, and the ability to work independently to complete assigned job functions
List of Typical Experience For a Patient Account Rep Resume
1
Experience For Workers Comp-patient Account Rep Resume
- Demonstrated communication and problem solving skills and the ability to act/decide accordingly
- Verify validity of account balances by researching, reviewing and ensuring accuracy of payment and adjustment posting
- Experience working in a professional office setting
- Identifies trends and their root cause to improve the effectiveness and efficiency of the
- Experience in healthcare collections and/or healthcare related field
2
Experience For Senior Patient Account Rep Resume
- Medical hospital collections experience
- Obtaining referral and surgery/procedure pre-authorizations from insurance companies, as needed
- Entering of charges from practice encounter forms, as needed
- Analyzing EOBs for accuracy when needed for claim resolution
- Daily monitoring and resolution of outstanding outpatient billing claims
3
Experience For Patient Account Rep Senior Resume
- Researches outstanding accounts by partnering with peers, vendors, and patients.
- Completes the NDC Error report daily by adding the missing NDC numbers to the patient account
- Responsible for performing billing, A/R follow-up and credit balance resolution activities
- Works the following queue’s daily or as needed: at risk, past due, pending reimbursement & variance to resolved
- Reviews and works the account receivables aging reports to meet specialty specific benchmarks for Days in A/R
- Identifies and corrects posting errors on patient accounts
- Participates in supporting the organization’s vision, mission and values and adheres to DeKalb Medical IREACH Standards of Behavior
- Interpret and apply reimbursement aspects of managed healthcare contracts and understand all basic aspects of hospital patient accounting reviews
4
Experience For Patient Account Rep-patient Financial Services Resume
- Daily depositing of cash/check payments from practices
- Periodic projects, as determined by supervising manager
- Partners with facility peers to resolve any edits or communicate any additional information needed to collect outstanding accounts.
- Researches outstanding issues to assist in the facilitation of timely account resolution.
- Maintain a working knowledge of insurance guidelines through newsletters and websites
- Valuables: Representative responsible for returning valuable envelop back to the patient or designee in conjunction with security
- Understands the basics of contracting
- Use critical thinking to research, review and follow-up on all accounts
- Analyze documentation and resolve patient, billing and/or collection issues appropriately and timely
5
Experience For Patient Account Rep-collections Resume
- Applies independent judgment and knowledge to audit Medi-cal payments, denials, appeals and billing issues
- Applies independent judgment and knowledge to audit Managed Medi-cal payments, denials, appeals and billing issues
- Applies independent judgment, research and knowledge to audit Commercial payor payments, denials, appeals and billing issues
- Reports recurring insurance payment discrepancies and works with team to resolve
- Documents all collection activities immediately, concisely, completely, and accurately following contact in the hospital system
- Review insurance aging reports
- Review and manage aging claims and accounts receivable, as well as comprehensive follow up to maximize reimbursement
- Works directly with customers in person, written or by telephone to assist them in understanding AMG West financial policy as it applies to their account
- Extensive knowledge of CPT, HCPCS and ICD-9 coding principles in a multispecialty physician practice
6
Experience For Patient Account Rep-medicaid Resume
- A comprehensive understanding of insurance requirements and regulations, contract benefits, credit and
- Inform Team Supervisor of any payor or other issues effecting collections
- Insurance follow-up – including Medicare and Medicaid
- Partners with facility billing personnel to ensure a consistent and timely follow up of claims.
- Electronic payment posting
- Electronic claim filing
- Reviews Explanation of Benefits (EOBs), research reasons for denials, ensure timely follow-up, identify trends and issues
- Reviews patient balances and works closely with patient(s) to ensure prompt payment(s), point of service collection and adhere to the collection polices prior to being turned over to collections
7
Experience For Patient Account Rep-pfs-prn Resume
- Works with the Practice Manager to answer billing questions, ensure correct insurance information obtained, including Navicure rejections, claim edits and unbilled encounters
- Works with Practice Manager and Providers to process clinical claim denials. To include Navicure rejections, claim edits reports and unbilled encounters
- Proficient with Medicare, Medicaid, Managed Care and Commercial payors timely filing, reason/remark codes, appeal process, denials, familiar with web portal to determine status of claims, redetermination/appeals and EOB/ERAs in order to enhance collections in a timely fashion
- Provide AR analysis to report issues and trends including aging buckets, total account/self-pay balances by payor specific and action plan needed to resolve identified problems
- Maintain productivity at the average production standard and quality assurance defined by the Revenue Cycle Department
- Coordinate workflow and train other employees
8
Experience For Patient Account Rep-patient Accounting Resume
- Performs account review to resolve regulatory and commercial accounts.
- Generates letters to patients for COBs or to obtain additional account information.
- Maintains escalation logs of accounts sent to patients and vendors for easy follow up.
- Field patient and insurance calls/visits regarding patient accounts receivables coming into the business Office with attempts to resolve issues and collect balance from patients
- Maintain daily collection goals by collecting payments from patients on patient account receivables, by making telephone calls to encourage timely payments and set up payment arrangements
- Work, A/R aging reports, review claims status, patient eligibility, accuracy of account information and modify as needed to ensure proper and timely payment
- Review patient charges for delinquency and make decisions regarding collection processes
- Review bankruptcy notification and discharges for adjustments to accounts. File claims to bankruptcy court. Review report from EPM quarterly to ensure timely follow up of bankruptcy claims
- Review deceased patient logs and reports weekly. Follow up on accounts to determine status of estate. Call appropriate probate court to determine estate status. Complete adjustment request when appropriate
9
Experience For Patient Account Rep-pfs Resume
- Review accounts for patient termination based on financial guidelines per practice policy. Send termination letter, review for completion of termination and send appropriate documentation to Medical Records
- Competitive Compensation - Excellent health benefits to include Medical, Dental, Vision, Prescription Drug Plan, Disability and Life Insurance
- Knowledge of UB-04 and 1500 bill forms
- Read an EOB
- Daily cash deposit: Daily receipt collection and preparation of deposit for Brinks, Cash Receipts Journal balancing, prep collection log for Finance and scanning all relevant documents into VI for Corporate posting. Also, does the GL posting of checks from Finance
10
Experience For Patient Account Rep-referrals Resume
- Processing of billing subpoenas by pulling billing documents as requested by attorney letters or subpoenas. Escalating to Director of Revenue Analysis if deposition is required
- Dialysis Invoice Review. Compares the charge sheets from the Dialysis department with what was actually posted to the patient account
- Monthly eReserve analysis as assigned by the Director of Revenue Analysis
- Responsible to manage outstanding accounts receivable for clients and/or assigned payers. Research and resolution of insurance denials for electronic and paper claims. Research, prepare and send appeals for payment to payers
- Within the last 18 months, 12 - 18 months charge and payment posting experience in a healthcare environment required. Knowledge of insurance companies, CPT and diagnosis codes as well as experience following billed and denied claims
- Leadership.Under the direction of leadership, train new and existing personnel in billing/registration functions; demonstrate efficient use of system applications; identify ways to streamline processes and methods within the department
List of Typical Skills For a Patient Account Rep Resume
1
Skills For Workers Comp-patient Account Rep Resume
- Schedules patients for department services, including calling patients to set up and confirm scheduled appointments and recording cancellations and rescheduling time slot
- Receives, collects, verifies, records, updates and distributes patient medical records, demographics and financial information in accordance with FHS standards and guidelines
- Two years experience doing insurance billing and/or two years accounting education
- Current medical billing experience, including knowledge of ICD-9 and CPT coding practices
- 12 months experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other), and General Office, or Computer Data Entry
2
Skills For Senior Patient Account Rep Resume
- To provide effective patient billing, problem solving and maintenance of financial computer records
- Demonstrated basic coding knowledge
- Provide excellent service when dealing with payors, patients, employers, management, hospital staff and other parties within and outside of THR
- Full cycle medical billing experience
3
Skills For Patient Account Rep Senior Resume
- Collections experience in the medical setting
- Hospital/Physician office experience involving use/knowledge of medical terminology
- Demonstrate ability to succeed in changing environment and handle growth
- Gathers and validates insurance information and contacts insurance companies to initiate and follow up on authorizations
- 12 months experience with medical claim follow-up
- Demonstrated ability to type 30 wpm, know 10 key by touch
- Demonstrated knowledge use of spreadsheets
- Experience with insurance claim appeals
4
Skills For Patient Account Rep-patient Financial Services Resume
- 2-3 yrs experience in a hospital or healthcare business office
- 1-3 yrs experience in business office, medical office, or insurance related industry
- Working knowledge of computer system functions
- Performs accurate and timely posting of patient claims using the revenue management billing system.
- Proficiency using scheduling software as well as a patient tracking database is required
- A basic understanding of accounting procedures such as debits/credits
- The incumbent follows protocol as it pertains to their particular clinic setting
- Handle calls through an automated or manual dialing process
5
Skills For Patient Account Rep-collections Resume
- Strict adherence to HIPAA, FDCPA, HiTech and all state and federal regulations relating to account collections and patient privacy
- Assists patients with difficult billing issues and researches patient accounts, bank reconciliation, etc. as applicable
- Shift Department: Commercial Billing and Follow Up
- Shift Department: Intermountain Pediatric Imaging
- Assists patients with difficult billing issues/complaints and researches patient accounts, bank reconciliation, etc. as applicable
- Shift Department: Commercial Follow Up for Hospital Billing
- Enter all communications regarding patient accounts in the host system
6
Skills For Patient Account Rep-medicaid Resume
- Accountable for the optical storage of information by scanning documents and mail distribution.
- One year of recent employment in a medical environment handling medical insurance claims
- Reviews incoming correspondence and takes appropriate action. Responds promptly to inquiries
- Shift Department: Commercial Billing
- Shift Department: Ortho Billing
- Assists in the managing of collection and self pay receivables
- Assists in the managing of insurance receivable
- Familiar with medical billing and/or medical insurance and practices
7
Skills For Patient Account Rep-pfs-prn Resume
- Collections: Bills patients' insurance companies both primary and secondary; makes / answers daily calls, re-bills insurance companies, collects past due amounts, deals with concerns / complaints, sets up budget plans, processes financial assistance, and explains insurance processed claims
- Performs the outlined code practice, insurance and co-pay as assigned. Makes adjustments to accounts and performs charge corrections
- Verifies insurance eligibility and submits claims/data to insurance carriers
- Verifies claim acceptance/rejection from carriers and makes adjustments
- Works appeals and denials with insurance companies
- Manages AR Days, 120 Days, and Bad Debt numbers
- Maintains productivity standards as measured by monthly productivity reports and average monthly accounts per day
- Provide customer service to carriers, patients and employees on accounts. Evaluate incoming Calls, Correspondence, QUIC's, Emails and complete necessary actions
8
Skills For Patient Account Rep-patient Accounting Resume
- Maintain acceptable call quality as determined Compliance, Legal, Quality and the Management staff
- Work an appropriate number of accounts each month as determined by Management and use appropriate account maintenance on each account worked, including entering notes which detail actions
- Adheres to and supports organizational IT&S standards, policies, and procedures
- Adheres to Code of Conduct
- Maintains established CHRISTUS Physician Group policies, procedures, objectives,
- Verifies insurance eligibility if appropriate. Submits claims and data to insurance carriers. Verifies claim acceptance or rejection from carriers and makes appropriate adjustments. Works appeals and denials with insurance companies
- Prepares and generates reports as appropriate. Works edit lists daily/weekly
- Manages AR Days, 120 Days, and Bad Debt numbers. Works with leadership to improve efficiency and reduce waste
9
Skills For Patient Account Rep-pfs Resume
- Maintains Intermountain productivity standards as measured by monthly productivity reports and average monthly accounts per day
- Shift Department: Behavioral Health Team
- Shift Department: Rehab Agency Team
- Prepares and generates reports as appropriate. Works lists as assigned
- Manages AR Days and 90 Days. Works with leadership to improve efficiency and reduce waste
- Use payor specific contracts terms to resolve claims that are in process or have a payment variance
10
Skills For Patient Account Rep-referrals Resume
- Take necessary steps needed to acquire and provide information needed for claims that have a zero payment
- Refer claims that have a clinical denial to the Denials team for review and follow-up
- Process rebills and other system actions, as needed
- Understand and apply appropriate system discounts
- Familiarity with electronic remittances
- Familiarity with government or commercial payors
List of Typical Responsibilities For a Patient Account Rep Resume
1
Responsibilities For Workers Comp-patient Account Rep Resume
- 0-4 years experience in Medical/Hospital Insurance related collections
- Six months experience in Hospital Business Operations Accounts Receivables
- Experience in a medical office or professional clerical environment
- Answer business office telephones and assist patients with account inquiries by routing callsto appropriate departments
- Evaluation.Assure required reports/logs and claim submissions are completed accurately and on time
- Understands Medicare, Medi-Cal HMO, PPO and 3rd party rules and regulations
- Works in a collaborative and team manner
- Responsible to handle self-payment options with patients including answer all patient phone calls, assist with billing questions, process credit card payments, open and distribute mail, organize courier bags and responsible for guests at MSO
2
Responsibilities For Senior Patient Account Rep Resume
- Provide prompt and courteous customer service to all internal and external customers
- Identify problems in a timely manner and initiate appropriate actions to resolve problems or issues
- Adheres to all confidentiality policies and procedures and carries out all tasks in a pleasant and respectful manner
- Works with all payors and internal resources to identify and resolve issues that hinder account payment
- Takes ownership of their accounts and eliminates barriers to ensure timely and correct payment including involvement with payors upper management, when necessary
- Proactively works with all payors and internal resources to identify and resolve issues that hinder account payment
- Reviews and processes insurance explanation of benefits statements for accuracy. Refers debit balances to collectors and refers credit balances for resolution
3
Responsibilities For Patient Account Rep Senior Resume
- Enters adjustments submitted in an accurate and timely manner
- Contacts responsible parties to request payments
- Maintains and makes collection efforts on 1200-1400 patient accounts per month with an average time of 5 to 7 minutes per account to review payment status online and by phone
- Experience in Medical/Hospital Insurance related collections
- Motivate managed care companies to pay promptly in accordance to the Florida Prompt Payment statute
- Knowledge of managed care regulations and contract language
- Business and department strategies
- Prepares and processes accounts for placement with external collection agencies
- Works directly with customers in person, written or by telephone to assist them in understanding AMG West financial policy as it applies to their account.Responsible for the integrity of the GE/IDX Billing Accounts Receivable database
4
Responsibilities For Patient Account Rep-patient Financial Services Resume
- Learn software related to position. (EPIC/IDX, etc.)
- None required. Continuous and repetitive manual movement associated with computer usage
- Effective oral and written communication skills required. Detail oriented focus on accuracy while meeting deadlines. Possess the experience to work with others. Experience with computers and Microsoft Office software necessary
- Working knowledge of collections helpful, but not required
- Collect, create and research complex or diverse information
- Other:Skills, knowledge and abilities: Demonstrated knowledge of computer & typing skills. Demonstrated knowledge in human relations & communications.Working conditions, mental and physical requirements
- Resubmit and work corrected claims and appeals
- Communicate with appropriate party (insurance company, attorney, place of employment, insured, etc.) for prompt account resolution
5
Responsibilities For Patient Account Rep-collections Resume
- Accurately document accounts with correct information received and take appropriate system action
- Audit assigned work to assure accounts are addressed timely
- Bills patients' insurance companies both primary and secondary
- Makes and answers daily calls, re-bills insurance companies
- Collects past due amounts, deals with patient concerns / complaints, sets up budget plans
- Processes financial assistance, and explains how insurance companies processed claims
- Inputs credit card payments from patients by phone or in person and bills secondary insurance as contracted
6
Responsibilities For Patient Account Rep-medicaid Resume
- Performs the outlined code practice as assigned. Performs insurance and co-pay follow up
- Makes adjustments to accounts and performs charge corrections
- Verifies insurance eligibility if appropriate AND verifies claim acceptance or rejection from carriers and makes appropriate adjustments
- Submits claims and data to insurance carriers. Works appeals and denials with insurance companies
- Proof of education and immunizations required!
7
Responsibilities For Patient Account Rep-pfs-prn Resume
- Moderate motor abilities for operation of calculator, typewriter and computer terminal.Accuracy is essential
- Basic mathematical proficiency required to include addition, subtraction, multiplication, and calculation of percentages
- In related position
- Knowledge of CPT (procedures), ICD-10 (diagnoses), and modifiers
- The ability to read and understand Explanation of Benefits (EOB's) or interpret denials
- Maintains an accuracy rate within the departmental guidelines and demonstrates the importance of quality and integrity of capturing patient information with regards to patient confidentiality.
8
Responsibilities For Patient Account Rep-patient Accounting Resume
- Knowledge of Epic or MediTech Systems
- Account Research/Patient Education
- Shift Department: Credit Team
- Entry Rate: $13.93
- Billing & Accounting.Assist leadership in overseeing the daily billing and accounting operations of the department, acting as a supervisor in his/her absence; troubleshoot billing problems; complete billing/registration functions and provide coverage as assigned; perform insurance verification and authorizations; process insurance rejections within established timeframes
- Call insurance carriers, patients, employers and responsible parties to acquire payment on assigned accounts. Identify/correct account errors that result in payment delays. Unresolved claims issues are to be placed in escalation weekly, biweekly, online rework . Follow-up on appealed accounts for correct reimbursement. Maintain productivity numbers in compliance with department standard
- Review system discounts for accuracy and insure correct plan code/financial class is loaded correctly. Calculate necessary manual adjustments, contractual discounts or write-offs according to contract or department policy. Identify and document insurance overpayments and forward request to Refund Department for processing. Notify management of recurring errors
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