Summary/Objective
Under limited supervision the Patient Account Representative will be responsible for effectively communicating with patients to explain medical billing and insurance claims, resolve inquiries, and ensure timely payment collection.
Essential Job Functions
- Initiate outgoing patient calls to discuss medical billing statements, insurance claims, payment collection, and related financial matters.
- Explain billing processes, insurance coverage, and payment options to patients in a clear and concise manner.
- Provide outstanding customer service by addressing patient inquiries, resolving billing discrepancies, and answering questions regarding insurance benefits and claim status.
- Verify patient demographic and insurance information, ensuring accuracy and making necessary updates as required.
- Update patient accounts with relevant information obtained during phone conversations, including payment arrangements, financial assistance applications, or any other relevant documentation.
- Work closely with insurance companies, coding specialists, and other team members to resolve any claim denials or issues impacting patient payments.
- Assist patients in understanding and navigating the process for filing insurance claims and submitting necessary documentation.
- Educate patients on financial assistance programs, payment plans, and available resources for managing medical expenses.
- Document all communication with patients accurately and thoroughly in the appropriate systems or databases.
- Adhere to company policies, procedures, and regulatory guidelines to ensure compliance with patient privacy (HIPAA) and collection practices.
- Performs other duties as directed.
- Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.
Key Success Indicators/Attributes
- Ability to prioritize and multi-task in a fast-paced, changing environment.
- Demonstrate ability to work in all work types and specialties.
- Demonstrate ability to self-motivate, set goals, and meet deadlines.
- Demonstrate problem-solving skills and the ability to think critically to identify and implement appropriate solutions.
- Demonstrate excellent verbal communication skills, with the ability to effectively explain complex billing and insurance concepts to patients.
- Strong active listening skills to understand patient concerns and provide appropriate resolutions.
- Maintain courteous and professional working relationships with employees at all levels of the organization.
- Work in accordance with corporate and organizational security policies and procedures, understand personal role in safeguarding corporate and client assets, and take appropriate action to prevent and report any compromises of security within scope of position.
- Ability to remain calm and composed in stressful situations, and effectively de-escalate any conflicts or disputes.
- Compassionate and empathetic personality to handle patient inquiries and concerns with sensitivity and professionalism.
- Skill in operating a personal computer and utilizing a variety of software applications is essential.
- Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation is an added advantage.
Supervisory Responsibility
No
Work Environment
This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and phones.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.
Position Type/Expected Hours of Work
This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.
Travel
Minimal travel required; up to 5%
Required Education and Experience
- Minimum of 1-2 years prior experience/knowledge of medical billing processes, insurance terminology, and reimbursement practices.
- Proficient computer skills and experience with electronic health records (HER) or billing software systems.
- High School diploma or equivalent, additional education in healthcare administration or related field is a plus.
- Proven experience in a customer service or call center role, preferably within the healthcare industry.
Preferred Education and Experience
N/A
Additional Eligibility Qualifications
N/A
Security Access Requirements
In addition to the specific security access required by the employee’s client engagement, the employee will have access to the Omega set forth in the “Omega Field Employee” profile.
AAP/EEO Statement
Omega is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.
Qualifications
- Minimum of 3 years prior experience/knowledge of medical billing processes, insurance terminology, and reimbursement practices.
- Proficient computer skills and experience with electronic health records (HER) or billing software systems.
- High School diploma or equivalent, additional education in healthcare administration or related field is a plus.
- Proven experience in a customer service or call center role, preferably within the healthcare industry.
About Us
Founded in 2003, Omega Healthcare Management Services™ (Omega Healthcare) empowers healthcare organizations to deliver exceptional care while enhancing financial performance. We help clients increase revenues, decrease costs, and improve the overall patient-provider-payer experience through our comprehensive portfolio of technology and clinically enabled solutions. Omega Healthcare has 30,000 employees across 14 delivery centers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com.
