Patient Account Representative Resume Sample
Stewart Huels
912 Deonte Glens,
Chicago,
IL
+1 (555) 214 8522
Work Experience
Senior Patient Account Representative
12/2016
-
PRESENT
Dallas, TX
- Insurance knowledge of insurance collections and insurance terminology
- Office/Team Work Environment
- Intermediate knowledge of UB-04 and Explanation of Benefits (EOB) interpretationIntermediate knowledge of CPT and ICD-9 codes
- Abstracting and coding (CPT and ICD) procedures and diagnosis from medical records
- Verify medical record documentation requirements
- Review charging procedures to insure compliance with Federal Regulations, Medicare and Medicaid Policies, etc
- Functions as advisor/educator to faculty in regard to charge documentation, diagnosis and procedure coding and charge policies
- Answers patient’s questions regarding statements, agency coverage, etc
- Record CPT codes on billing forms
Patient Account Representative
11/2010
-
06/2016
Boston, MA
- Record ICD-9 codes on billing forms
- Post receipts to proper patient accounts
- Compare batch proofs and source documents for accuracy
- 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
Bwpo Patient Account Representative
06/2005
-
09/2010
Phoenix, AZ
- Prepare other daily credit balances other than refunds
- Post refund checks to patient accounts
- Mail refund checks with supporting documentation
- Balances batches by comparing batch proofs to source documents and cash totals
- Operates current information system terminal to obtain patient information, patient insurance information and status of approvals or denials
- Assists in resolving department problems with current software billing used
- Maintains records of charges, payments and/or issue payment receipts
Education
Northwood University - Florida Campus
1999 - 2004
School's Degree in Management
Professional Skills
- Strong computer skills, including experience with Intranet and Internet usage, Excel, Word, email, web based applications
- Excellent typing skills with accuracy
- Strong computer skills including knowledge of EPIC
- Strong Interpersonal skills, service orientation and team work
- Demonstrated math skills to calculate patient bills and patient refunds
- Strong telephone, customer service and communication skills
- Strong interpersonal skills; both verbal and non-verbal
How to write Patient Account Representative Resume
Patient Account Representative role is responsible for customer, computer, telephone, organizational, interpersonal, insurance, medical, microsoft, epic, billing.
To write great resume for patient account representative job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Patient Account Representative Resume
The section contact information is important in your patient account representative 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 Representative Resume
The section work experience is an essential part of your patient account representative 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 representative 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 representative position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Patient Account Representative resume experience can include:
- Solid analytical, quantitative and numerical skills
- Work requires advanced reading, writing and oral communication skills as well as the knowledge to perform
- Three (3) years business experience; including medical insurance billing required, ORthe equivalent combination of education and experience
- Proven experience reviewing EOB's and interpreting health plans payment policies, rules and guidelines
- Knowledge of medical terminology and anatomy is required. Sound computer skills and typing speed of 45 wpm is required
- Work requires interpersonal skills necessary for making patient and third party payer contacts
Education on a Patient Account Representative Resume
Make sure to make education a priority on your patient account representative 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 representative 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 Representative Resume
When listing skills on your patient account representative 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 representative skills:
- 1)Effective telephone techniques and listening skills required
- Good Customer Service skills: explaining insurance benefits and self-pay balances to patients
- Effectively operate EMR system to update information in patient database
- Strong communication and telephone skills with confidence in ability to make calls to insurance companies
- Strong telephone communications skills are required
- Good data entry skills
List of Typical Experience For a Patient Account Representative Resume
1
Experience For Senior Patient Account Representative Resume
- One year of healthcare experience desired. Requires three to six months on-the-job training to become familiar with billing practices and policies
- Experience in Medicare and physician billing
- Independently prioritizes workflow to meet deadlines and productivity levels
- Three (3) or more year’s job related experience in a hospital or clinic environment patient finance is required
- Performing medical billing and accounts receivable functions including collections
- Using alphanumeric keyboard transcribes and/or verifies data from source documents to the medium used for entering data into the computer
2
Experience For Lead Patient Account Representative Resume
- Working knowledge of Microsoft Office Suite products, including but not limited to Excel, Outlook, PowerPoint, and Word
- Working knowledge of billing and reimbursement policies as well as compliance regulations of third party payors and governmental payors
- Working knowledge of both government and commercial insurance benefits to include deductibles, copays and out of pocket/coinsurance
- Collecting accounts receivable from insurances and patients
- Tallying up patient deductibles, coinsurance and copays to collect from patient at admission or discharge
- Utilizes critical thinking to analyze trends (problem solving), and to engage in/recommending solutions
- Monitor insurance claims by running/reading appropriate reports and contacting insurance companies to resolve claims that are not paid, denied or underpaid
- Occasional standing, walking, lifting
3
Experience For Senior Patient Account Representative Collections Resume
- Assists in reviewing and balancing the current software transaction reports for administration
- Record CDT codes on billing forms. Record CDT codes on billing forms
- Interfaces with patients, dentists, and others regarding professional billing operations and funds
- Assists in reviewing and balancing the current software transactions reports for administration
- Performs moderate office functions; fax, copy, scan, email, Outlook scheduling, programming Image Send
- Escalate denials via the payer appeals process, gathering appropriate supporting documentation
- Maintain up-to-date knowledge of current issues and regulations pertaining to billing, reimbursement, and collections
4
Experience For Patient Account Representative Verifications Resume
- Reviews and edits any rejections stemming from electronic billing submissions and corrects and resubmits claims, as required
- Identify coding, billing and underpayment issues from EOBs and coordinate with the correct departments to ensure resolution in a timely manner
- Verify Financial Class and Balances when reviewing and working accounts
- Assist in resolving negative credit history reporting for consumers
- Initiate and monitor financial planning for patients
- Strict adherence to HIPAA, HiTech and all state and federal regulations regarding account collections and patient privacy
- Review patient screening records and extracts relevant information
- Balance by comparing batch proofs to source documents
- Completes processing of all patient documents received on a daily basis
5
Experience For Bwpo Patient Account Representative Resume
- Initiates contact with patients and /or third party carriers if there is a delay in responding to statements or claims
- Contacts insurance carriers regarding non-payment and/or improper payment of claims. Reviews denials
- Obtains accurate patient demographics and insurance information, adhering to current hospital standardization practices
- Schedules patients for surgical procedures in the appropriate Surgical Scheduling module
- Collect payment from patients on patient account receivables, making telephone calls to encourage timely payment and set up payment arrangements
- Maintain A/R aging within practice guidelines
- Greet and counsel patients regarding coverage and payments on accounts
- Record CDT codes on billing forms
- Assemble claims to be submitted and upload to claims clearinghouse for processing
6
Experience For Senior Senior Patient Account Representative Resume
- Review rejected claims and re-bill when appropriate, identifying causes of claim denials
- Cross trained in all phases of third party billing, follow-up, credit and collections and customer service related activities
- File claims as needed using all appropriate forms and attachments
- Respond to payer requests for supporting documentation
- Prepares the daily cash deposit and assures the daily posting to patient account
7
Experience For Bwpo Senior Patient Account Representative Resume
- Follow-up on pending claims in Epic
- Assists with training new Patient Account Representatives
- Detailed oriented - verifying all required paperwork has been obtained from the patient
- Thorough understanding of medical insurance reimbursement and payment methodology and insurance company interaction are required
- Identify refunds & notify credit balance department
- Post receipts to proper patient accounts, post denials, compare batch proofs and source documents for accuracy
- Reconciles and balances daily current software receivables reports
- Prepares and processes deposits for the department
8
Experience For Patient Account Representative Biller Resume
- Attention to detail and data entry accuracy
- Communicates professionally with physicians, physicians’ office staff, co-workers and patients, providing excellent customer service and works collaboratively with a variety of individuals
- Verifies that physician order matches scheduled or requested procedure
- Answers all incoming phone calls within three rings with proper greeting 100% of the time. Continuously checks department and individual phone messages throughout the day, returning phone messages within one hour
- Two years of previous surgical scheduling and pre-registration experience required
9
Experience For Medicare Patient Account Representative Resume
- Participates in basic Kaizen processes; Q&E, Standard Work validation, assist in 4SPS
- Utilizes limited problem solving to identify trends and engage in solutions
- Faxes confirmations immediately as the case is posted and/or schedules inquiries upon request of offices
- Rearrange schedules upon the request of physicians or physicians staff and/charge nurse of ACP OR or ESP
- Performs basic office functions; fax, copy, scan, email
- Stays up-to-date on and demonstrates a basic understanding of payer explanation of benefits (EOB); comprehension of correct contractual adjustments and balance billing
10
Experience For Patient Account Representative Resume
- Meets performance standards as defined in your focus area for productivity, quality and results
- Be able to hear normal speech
- Reconciles and balances daily current software receivables reports. Prepares and processes deposits for the department
- Participates in moderate Kaizen processes; Q&E, Create Standard Work, lead 4SPS within department
- Maintain self-pay accounts receivables within practice guidelines
- Maintain and monitor all budget plans to ensure compliance with plan
- Review and reply to all correspondence
List of Typical Skills For a Patient Account Representative Resume
1
Skills For Senior Patient Account Representative Resume
- Excellent communication, listening and negotiating skills and customer relations principles
- Demonstrated active listening, as well as, written, verbal, and information technology skills
- Medical billing terminology and knowledge of insurance payers desirable. Good communication skills, both oral and written
- Strong written/verbal communication and customer service skills
- Analyze data-Strong telephone communication skills are required
- Excellent keyboard and computer skills with the appropriate applications
- Working math aptitude and critical thinking skills
- Basic typing, data entry and computer skills
2
Skills For Lead Patient Account Representative Resume
- Excellent understanding of the A/R process in relation to the revenue cycle as well as good knowledge of healthcare, government and/or insurance industry
- Analytical with Problem Solving Skills
- Possesses basic analytical skills to determine areas of focus within assigned accounts
- Experience within a healthcare environment. Medical claims experience
- Moderate computer and math skills and ability to utilize multiple computer programs as required
3
Skills For Senior Patient Account Representative Collections Resume
- Able to effectively and respectfully communicate
- Prior experience in Medical Office Environment
- Anticipate patient concerns and answer politely and effectively
- Prior experience with follow-up of insurance denials and no activity
- Demonstrates excellent internal/external customer service
- Prior experience with follow up of insurance denials and no activity
- 3) Prior experience with follow-up of insurance denials and no activity
- Billing UB-04s daily - 2 years of previous billing experience
4
Skills For Patient Account Representative Verifications Resume
- Providing excellent customer service to client and Atos staff
- Working experience using MicroMD, Cerner and/or Epic
- Excel experience - filtering, sorting, analyzing loaded data
- Handle incoming and outgoing phone calls, providing excellent customer service
- Experience performing financial transaction processing in a medical setting
- Experience with hospital medical insurance claims processing procedures, including appeal workflows and follow up of denials
- Excellent problem solving, organization and multi-tasking abilities
- Electronic billing systems experience including government and group health plans
5
Skills For Bwpo Patient Account Representative Resume
- Experience in a hospital business environment performing billing and/or collections
- Experience in a medical claims/medical billing role working with facilities, providers and members
- 36 months experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other), and General Office, or Computer Data Entry
- 36 months experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other)
- Experience dealing with explanation of benefiter and interpreting them
- 18 months experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other)
- Experience working with all appropriate payers
6
Skills For Senior Senior Patient Account Representative Resume
- Solid understanding Insurance Deductible and Co-insurance
- Previous experience with Accounting Management
- Strong understanding Insurance Deductible and Co-Insurance
- Electronic billing systems experience
- Computerized medical billing experience
- Accounts Receivables (AR) Accounting system experience
- Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons
- Experience in a Medical Billing role
- Candidates with Medical Billing externship experience welcome!
7
Skills For Bwpo Senior Patient Account Representative Resume
- Medical Billing Experience
- Medical Billing and/or Medical Admin experience required
- Experience working with Oncology or Clinical Trials
- Experience in data entry, verifying insurance, and insurance follow up in a medical environment
- Identify missing or incorrect data on UB04 and correct claims in X Claim prior to submission to insurance carriers
- Experience in healthcare insurance accounts receivable follow up, working directly with government or commercial insurance payers
- Experience navigating payer sites for appeals/reconsiderations, benefits verification and online claims follow up
- Stays up-to-date on and demonstrates a moderate understanding of payer explanation of benefits (EOB); comprehension of various denial reasons
8
Skills For Patient Account Representative Biller Resume
- Hospital billing Medicare experience
- Provide excellent customer service when responding to patient inquiries and request
- Commercial/managed care hospital billing experience
- VA and Tricare hospital billing experience
- Or more years’ experience in surgical billing within a medium to large health care system
- One (1) to three (3) years of experience in medical business office and/or hospital setting
- ICD-9 and/or ICD-10 coding experience
- Billing or customer service experience required
- One year of related experience in medical billing
9
Skills For Medicare Patient Account Representative Resume
- ICD-9 coding experience required
- Two years' experience in a healthcare hospital or office setting
- 1-2 years' experience in related field or education
- Experience with medical billing or collections
- 2+ more years of customer service experience
- Mush have the ability to prioritize and multi-task
- Medical Front Office experience required
- Excellent knowledge of HIPAA guidelines
- Experience with insurance contract interpretations
10
Skills For Patient Account Representative Resume
- Experience with explanation of benefits
- Complete task daily basis and prioritize work
- Work experience with Commercial, Medicare or Medi-Cal reimbursement processes
- Medical Commercial Insurance Experience
- Insurance Verification and BenefitsExperience
- Experience with Epic, Meditech, Cerner, Invision, Paragon, Soarian or STAR
- Intermediate experience with Microsoft Word / Excel
- Strong Medicare and insurance payor knowledge
List of Typical Responsibilities For a Patient Account Representative Resume
1
Responsibilities For Senior Patient Account Representative Resume
- Provide assistance, coaching and training to staff members, including new hires. Provide enhanced training and assist staff with techniques to increase production, quality and collections
- Edit claims to meet and satisfy billing compliance guidelines for electronic submission. Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory
- Accurately and thoroughly documents the pertinent collection activity performed. Review the account information and necessary system applications to determine the next appropriate work activity
- Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical consultations or account referrals when necessary,
- Demonstrates effective interpersonal skills which promote cooperation and teamwork
2
Responsibilities For Lead Patient Account Representative Resume
- Excellent interpersonal/human relations skills required
- Strong telephone communication skills are required
- Strong analytical and interpersonal skills and ability to interact with payers in a professional manner
- Have good work history and communication skills
- Telephone communication skills are required
3
Responsibilities For Senior Patient Account Representative Collections Resume
- Is able to interview patients in all areas and effectively gather patients information for a complete and accurate registration
- Dental/medical coding experience required
- Experience with accounts receivable software
- Demonstrated competence in Medicare billing and collection
- Healthcare receivables experience
4
Responsibilities For Patient Account Representative Verifications Resume
- Healthcare receivables experience
- 3-5 years administrative experience
- Medical Patient Account experience
- Previous hospital collection experience with emphasis on claims research and resolution
- Experience in a call center type of environment
- Experience in Medical/Hospital Insurance related collections
- Medical Hospital collections experience
- Related experience
5
Responsibilities For Bwpo Patient Account Representative Resume
- Experience in Medical/Hospital Insurance related collections
- The ability to operate standard office machines; basic application of computers and Microsoft Applications (i.e. Word and Excel)
- Experience in insurance follow up of denials and no activity
- Customer service experience in healthcare industry
- Knowledge of insurance benefits which includes, deductibles, co-insurance, out-of-pocket, plan exclusions and prior authorization requirements
- Experience with use of Microsoft Office applications, computer systems and software
- Certified coder with experience in collections for an ambulatory primary care facility
- Experience in an outpatient pediatric front office
- Scanning, filing, faxing, copying, data entry, typing and other general clerical tasks as needed
6
Responsibilities For Senior Senior Patient Account Representative Resume
- Working knowledge of insurance regulations, including but not limited to: commercial insurance, Medicaid, Medicare and managed care plans desirable
- Understanding of the UB-04 hospital claim form, as well as standard CPT, HCPCS & ICD10 coding terminology
- Obtaining insurance referrals and authorizations
- Posting a high volume of payments
- Working knowledge of spreadsheet and word processing programs
- Communicating with client to ensure prompt resolution of their issues
- Knowledge of third party payer contracting language and reimbursement terms. Knowledge of medical terminology, ICD10, CPT, and HCPC coding
7
Responsibilities For Bwpo Senior Patient Account Representative Resume
- Familiar with multiple (widely used) healthcare patient accounting/billing systems
- Responsible for resolving outstanding unpaid or unprocessed medical claims and denied claims submitted to third party payors
- Prepares and maintains records and reports documenting the status of all insurance verification and census information reporting
- Provide account and billing information to patients, insurance companies and/or collection agencies
- Enters data related to patient demographics and insurance for billing into software programs
- Familiarity working with Michigan Medicine's electronic medical record systems
- Appropriate manual dexterity to enable typing (including10-key) throughout a work day/shift
- Lift up to 25lbs, safely, from ground to waist using proper body mechanics
8
Responsibilities For Patient Account Representative Biller Resume
- Knowledge of insurance, billing, & collections processes
- Document and report findings to peers verbally in a large setting
- ICD-9 and CPT IV coding
- Clerical testing is required -Ability to type 30 wpm with 70% accuracy
- Complete understanding on how to read an Itemized Bill
- Attendance and being on time, ready to work your scheduled hours is and essential job requirement
- Knowledge of ICD9-10 and CPT coding is required
9
Responsibilities For Medicare Patient Account Representative Resume
- Appeals. Once a claim is denied and an appeal is appropriate, appeals are to be done on a timely basis in order to avoid the filing limit
- Knowledge of ICD-10 & CPT Coding
- Be seeking a permanent opportunity
- Focus on Professional Billing and AR follow up
- Comfortable meeting performance metrics with self-direction and ability to multitask
- Answer telephone calls coming into Business Office with attempts to resolve issues and collect balance from patients
- Collect self-pay account receivables, making telephone calls to encourage timely payments and set up payment arrangements
- Review budget plans to ensure terms and conditions of agreement are being met
10
Responsibilities For Patient Account Representative Resume
- Collect payment from patients on patient account receivables, 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
- Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations
- Follow specific payer guidelines for appeals submission
- Escalate exhausted appeal efforts for resolution
- Work payer projects as directed
- Research contract terms/interpretation and compile necessary supporting documentation for appeals, Terms & Conditions for Internet enabled Managed Care System (IMaCS) adjudication issues, and referral to refund unit on overpayments
- Perform research and makes determination of corrective actions and takes appropriate steps to code the DCM system and route account appropriately
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