Patient Accounts Rep Resume Sample
Kenya Ledner
27824 Jade Square,
Houston,
TX
+1 (555) 477 8074
Work Experience
Patient Accounts Rep-senior
06/2016
-
PRESENT
Los Angeles, CA
- Performs all clerical functions required to handle a request to completion. Interacts with other Carolinas HealthCare System departments, physicians' offices, insurance companies, and attorneys’ offices to resolve issues
- Gathers all charges and prepares and transmits them
- Analyzes log sheets of patients that have been billed to ensure billing is correct before transmitting charges
- Checks financial proof for errors and corrects as necessary
- Assists with manual bills if there are any necessary charges
- Provides explanation for all late charges and medical audit billing errors
- Assists with any performance improvements activities
- Follows up verbally and online with claim status to Medicare and Medicare Advantage insurance companies on accounts aged 30 days or more
Patient Accounts Rep
08/2012
-
01/2016
Boston, MA
- Post lockbox patient, insurance payments, and denials with patient coinsurance, co-pays, and deductible amounts listed on the explanation of benefit to the appropriate patient accounts daily
- Knowledge of government insurance, PPO, Indemnity, HMO, Medicare Risk (etc) billing, policies and procedures
- Knowledge and understanding of clinical laboratory tests/procedures
- Typing skills of 45 wpm
- Excellent verbal and written communication/articulation skills required
- Key keyboarding
- Review and research each credit balance
- Determine recipient of refund or appropriate account adjustment
Patient Accounts Rep Days
06/2007
-
04/2012
Phoenix, AZ
- Call patients and third party payers
- Review EOB’s and supporting documentation as needed
- Process refund requests for both insurance companies and patients
- Responsible for reviewing denial reports and following up verbally and in writing on claim status to insurance companies
- Handles incoming correspondence and telephone calls from insurance companies and patient referrals
- Responsible for following up on appeals performed, and entering the appropriate adjustments
- Responsible for generating denial re-considerations and appeals resulting in payment from the payer and/or account resolution
- Meets and maintains a per productivity standard
Education
California State University Channel Islands
2003 - 2007
School's Degree in Communication
Professional Skills
- Strong communication skills with all levels of personnel and external customers
- Previous experience in a hospital services setting and experience with mental health and substance abuse services
- Experience required. Billing, collection, medical insurance processing, experience desired
- Basic typing and good communication skills
- For admissions positions, one year of experience in a healthcare environment or one year of customer service experience is required
- Effective communication and mathematical skills
- 2~3 years experience required. Billing, collection, medical insurance processing, experience desired
How to write Patient Accounts Rep Resume
Patient Accounts Rep role is responsible for typing, basic, analytical, word, insurance, benefits, credit, training, database, contracts.
To write great resume for patient accounts rep job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Patient Accounts Rep Resume
The section contact information is important in your patient accounts 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 Accounts Rep Resume
The section work experience is an essential part of your patient accounts 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 accounts 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 accounts rep position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Patient Accounts Rep resume experience can include:
- Experience in billing, collections, registration, or related hospital / office environment
- Demonstrates knowledge of patient account policies
- Documenting all facets of the registration process and meeting accuracy goals
- Identifying and resolving coverage and reimbursement delays
- Assisting with COBRA coverage and/or financial assistance applications
- Handling point of service collections
Education on a Patient Accounts Rep Resume
Make sure to make education a priority on your patient accounts 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 accounts 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 Accounts Rep Resume
When listing skills on your patient accounts 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 accounts rep skills:
- Listen and speak effectively with individuals via telephone to obtain information
- Performing effective financial counseling
- Experience in operating a 10~key calculator
- Previous Medicare billing experience
- Experience with cash posting/reconciliation
- Previous experience with insurance benefits, financial counseling, and cash collections
List of Typical Experience For a Patient Accounts Rep Resume
1
Experience For Bwpo Patient Accounts Rep Resume
- Obtaining authorizations and forms needed to maximize reimbursement
- Calculating out-of-pocket responsibility
- Determining insurance eligibility and benefit coverage details
- Knowledge of all Patient Accounting systems including PTIQ, EDM, MEDA, X-claims, Insurance websites, and Med Metrix
- Process correspondence which requires a response from the Credit Processing department
2
Experience For Patient Accounts Rep Days Resume
- Familiar with ICD-10 and CPT coding
- Works directly with internal and external customers to resolve system and claim related questions/problems and escalates issues and concerns to the
- Maintains acceptable turnaround time
- Investigates and processes a high volume of credit balances daily
- Provides individual contributions to meet or exceed department goals by consistently meeting individual productivity standards and targeted error ratios in processing credit balances
- Reads, interprets, and understands insurance correspondence including both explanation and coordination of benefits
3
Experience For Patient Accounts Rep / PFS Credit Processing Resume
- Coordinates to resolve issues requiring in-depth follow-up with UBO leadership, physicians' offices, insurance companies, attorneys’ offices, or other CHS departments
- Retrieve check copies and EOB’s as needed
- Posts and balances a high volume of lockbox and patient payments; Posts agency and payroll deduction files timely and accurately and provides leadership with any required reporting
- Secures any cash, or other types of payments in a safe and prepare a deposit of all payments on a daily basis
- Ensures all payments are posted and all batches are approved and balanced daily and by the end of the month
- Mseet or exceeds department goals
- Verifies patient information with third party payers. Collects insurance referrals and documents within EPIC. Communicates with patients and physician/offices regarding authorization/referral requirements. Obtains financial responsibility forms or completed electronic forms with patients as necessary
4
Experience For Patient Accounts Rep, / Lansdowne Station Resume
- Manages/prepares miscellaneous reports, schedules and paperwork. Maintains inventory of supplies
- Searches appropriately for patient's medical record and identifies duplicate medical records for merge
- Maintains and exceeds the department specific individual productivity standards, collection targets, quality audit scores for accuracy productivity, collection and standards for registrations/insurance verification
- Provides excellent service to clinical and interdepartmental teams and physicians as customers of registration services. Contributes to process improvement activities to support an efficient patient and process flow
- Maintains or exceeds the Beaumont Customer Service Standards: Service, Ownership, Attitude, and Respect. Provide every customer with a seamless, flawless Beaumont experience
5
Experience For Patient Accounts Rep-biller Resume
- Basic web skills
- Previous refund experience
- Remains compliant with regular TB testing & Flu vaccination per Hospital requirements
- Knowledge of DRG schemes, Managed Care contracts, as well as ICD9 and ICD10 to ensure accurate reimbursement along with APC rates
- Make basic numerical caluclations
- Process refund requests
List of Typical Skills For a Patient Accounts Rep Resume
1
Skills For Bwpo Patient Accounts Rep Resume
- Experience with paper and electronic claims filing
- Demonstrates understanding of both UB04 claim form and CMS 1500 claim form
- Experience with credit balances
- Work experience with MedSeries/AS400, Citrix/MIDAS, Change Healthcare, Passport software/programs and processes
- Strong mathematical acumen required
- Understanding of provider/payor contractual relationships, reimbursement rates and provider/payor limitations/exclusions
- Responsible for creating correspondence in appropriate communication regarding denials, cash posting, problem accounts between the Resolution
2
Skills For Patient Accounts Rep Days Resume
- Resolves credit balances by transferring credits between guarantor accounts as appropriate, or by calculating and posting a refund
- Aids in the cash balancing process by preparing and entering daily deposits into the cash management database
- Responsible for any special projects related to obtaining appropriate and timely reimbursement of claims outstanding
- Performs various collection actions, including contacting third party payers or patients by phone and resubmission of claims for appeal process
- Reports and resolves variances and inefficiencies, escalating accounts as necessary to resolve billing issues
- Submits refund requests, provides all proper supporting documentation, and documents account activity in the patient billing system
- Handles incoming correspondence and telephone calls from insurance companies and patients which requires a response from the Cash Posting department
- Responsible for maintaining the integrity of all Patient and Insurance demographic information for the Patient Accounts
- Regularly requires ability to sit, and use hands to finger, handle or feel, reach and grab with arms and hands including repetitive motion
3
Skills For Patient Accounts Rep / PFS Credit Processing Resume
- Current working knowledge of patient financial services and how to interpret and apply insurance coverage details to services
- Knowledge in the use of patient registration and accounting software, MS Word, Excel, and database software
- College education and/or related training
- Follows-up on denials in a timely manner and proactively communicates any denial issues related to billing requirements
- Understands billing requirements for contracted and commercial payers
4
Skills For Patient Accounts Rep, / Lansdowne Station Resume
- Understands commercial compliance regulations related to healthcare billing and accounts receivable management and where to locate the regulations
- Obtains necessary documentation for billing and obtains pre-certifications
- Enters all charges and submits bills in accordance with Patient Accounting policy
- Processes correspondence which requires a response from the Credit Processing department
- Performs all clerical functions required to process a credit balance using available information and resources
- Researches and resolves unidentified payments in the patient billing system
- This is a 20 hour a week role with benefits
- Bill the patient’s account to third party insurers
5
Skills For Patient Accounts Rep-biller Resume
- Follow up with both insurers and patients for their respective balances
- Recommend placement of the account if payment cannot be obtained
- All work is performed at the main business office at 111 Cypress Street, Brookline, MA, in an office environment
- The Patient Account Representative is responsible for all patient accounts and the resolution of insurance issues through collection of payments, appropriate adjustments, and when all collection efforts are exhausted, referring account balances to collection agencies
- Acquires and maintains knowledge of Government Regulations, Insurance Contracts, legal matters pertaining to collections, lawsuits, third party liability, probate, etc., to maximize reimbursement.
- Solve practice problems involving several concrete variables in standardized situations
- Read medical coding, and use and interpret medical record terminology
- Read and interpret documents such as Explanations of Benefits and procedure manuals
- Write/run routine reports and correspondence
6
Skills For Patient Accounts Rep / PFS Variance Resume
- Regularly requires ability to talk and/or hear
- Occasionally requires ability to walk and stand
- Includes exposure to moderate noise levels within an office environment
- Extensive knowledge of the payment/charging reimbursement methodology, coordination of benefits, government collection issues, and insurance contract agreements
- Able to carry objects up to 25 pounds
- Analyze and determine third party payor payments for accuracy
7
Skills For Patient Accounts Rep, / PFS CBO Northeast Resume
- Greater than one year of current work with collections services and health insurance industry standards
- Greets customers promptly with a warm and friendly interaction. Directs patients to appropriate setting, explaining and apologizing for any delays. Maintains professionalism at all times and follows specific standards as defined in the department professional policy
- Financially clears patients for each visit type, admit type and area of service via EPIC (Electronic Medical Record- EMR). Collects and documents all required demographic and financial information. Appropriately activates registration and discharges in a timely fashion
- Reviews reports of patient accounts with duplicate charges; apply account credits. Review reports and patient records for missing billing information; correct registration information, retrieve ABNs, contact providers for diagnosis codes, input information and resubmit for billing
- Reviews EOB for proper reimbursement
- Monitors contracts and single patient agreements to ensure appropriate reimbursement is received
8
Skills For Patient Accounts Rep-eye Institute Resume
- Ensures timely filing requirements are met and claims are followed-up on in a timely and appropriate manner, to eliminate timely filing denials and non-payment of claims
- Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment
- Follows-up on unpaid/unresolved account balances on a daily basis and notates follow-up response on patient accounts
- Completes re-bill request as necessary to facilitate timely and proper claims payment
- Evaluates patient financial status and establishes budget plans
- Answers inquiries and correspondence from patients and insurance companies to facilitate payment
9
Skills For Patient Accounts Rep / CSR / PFS Resume
- Demonstrates ability to work effectively with and interact with patients and co-workers in a professional, caring, and courteous manner that adheres to FRN’s Mission and Statement of Values
- Understands and maintains confidentiality at all times
- Identifies items to be billed by procedure and services performed
- Posts payments, performs daily reconciliations, produces daily census, and performs month end close
- Maintains data in billing management system, i.e. updating current and adding new demographic information, and ensures that documentation entered is accurate and complete
- Analyzes, identifies and trends billing issues to proactively reduce denials and variances
- Works system generated reports such as residual balance, credits, no-pay
- Interacts / communicates effectively with various department staff and assists customer service inquires both internally and externally: liaison with Patient Accounting and Physician billing services, employers and insurance carries to ensure accurate and timely billing process
10
Skills For Patient Accounts Rep PFS Credit Processing Resume
- Maintains open communication with management regarding billing and coding issues including documentation, denials/appeals, etc
- Follows up on assigned insurances on a monthly basis and maintains records of declined claims requiring appeals
- Reports recurring insurance payment discrepancies and works with team to resolve. Identifies accounts on which contractual adjustments are incorrect by working the daily credit balance report
- Reconciles bank deposits to payments entered into the financial system in a timely manner to ensure accurate account data
- Reviews accounts and responds in a timely manner. Responds to third party inquiries and works to resolve circumstances that create unwarranted debit/credit balances
- Collects CPT and ICD-10 codes. Performs medical necessity check and issues ABN as appropriate for Medicare primary outpatients
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