Antelope Valley Medical Center
Patient Account Representative- Business Office - Full Time/Days - Req#209743391
Antelope Valley Medical Center, Lancaster, California, us, 93586
Patient Account Representative - Business Office (Full Time, Days) – Antelope Valley Medical Center
Under the supervision of the Collection Supervisor, Director, or designee, performs patient account follow-up, credit balance review and resolution, keeping the hospital's accounts receivable as accurate as possible.
Brief Description Perform patient account follow-up, credit balance review and resolution, keeping the hospital's accounts receivable as accurate as possible.
Duties and Responsibilities
Insurance Follow-up, as assigned
Contact insurance carriers regarding outstanding balances until resolution
Resubmit bills to insurance carriers as needed
File insurance carrier appeals for payment and/or denial disputes
Validate accounts for accurate payments, discounts, and contractual adjustments
Reply to insurance carrier correspondence as appropriate
Answer incoming calls, resolving patient, insurance, and/or vendor issues timely
Patient Follow-up, as assigned
Contact patients regarding outstanding balances until accounts receivable resolution
Validate bills for accurate discounts and contractual adjustments
Set up payment plans and monitor until resolution
Refer uninsured accounts to Pre-Collection
Assign patient accounts to Bad Debt when appropriate
Communicate with TPL agencies and attorneys
Process bankruptcy notifications
Review charity care applications and refer to the Director, or Collection Supervisor, for approval or denial
Credit Balance, Physician Payment, Trauma Billing, Client Billing, and Miscellaneous Reports Processing, as assigned
Process refund requests for patients and insurance carriers
Process uninsured claims for specialty physicians
Track and trend Medicare Bad Debt assignments for the Cost Report
Research unidentified checks for posting corrections
Non‑Essential Duties
Cancel Medicare and Medi‑Cal eligible accounts from collection agencies, as assigned
Assist with other duties as assigned, within skill sets and abilities
Knowledge
Working knowledge of HMO, PPO, Commercial, Medicare HMO, Medi‑Cal HMO, Government, and Workers' Compensation reimbursement
Working knowledge of Managed Care contract language and interpretation
Working knowledge of Microsoft Office applications
Knowledge of basic arithmetic
Skills
Proficient in basic personal computer
Proficient in the use of a calculator
Proficient in the operation of scanners, copiers, and fax machines
Abilities
Ability to handle stress
Ability to manage a heavy caseload in an organized and efficient manner
Ability to recommend appropriate account adjustment and write‑off suggestions
Ability to recognize potential accounts receivable related problems and offer solutions to management
Ability to maintain a working relationship with other departments within the organization
Ability to review all billing transactions for accuracy, discrepancies, and appropriate charges
Ability to document account information at time of account follow‑upAbility to run accounts receivable reports as needed
AVH Values
Patients Come First – We listen actively and communicate with our patients and families, placing safety as a top priority.
Accountability & Ownership – We fully complete tasks, are transparent, effectively communicate, and recognize that what we do reflects on us.
Teamwork – We build trusting relationships, promote a sense of community, and are respectful of everyone. Success is about the whole team.
Integrity & Honesty – We tell the truth at all times, speak up when something is wrong, and do the right thing when no one is looking.
Excellence – We take pride in our work, are goal‑oriented, and on a never‑ending quest for top tier quality.
Initiative & Innovation – Our can‑do attitudes, creativity, and resourcefulness empower us to improve the patient’s experience, solve our own problems, make timely decisions, and look for opportunities to add value.
Tenderness & Compassion – We have genuine empathy, show kindness, and encourage and advocate for each other.
Education
High School graduate or equivalent
Experience
Minimum 1‑year previous Commercial, HMO, PPO, Medicare HMO, Medi‑Cal HMO, Government, and Workers' Compensation billing and Insurance follow‑up experience
Will consider 2‑years’ recent acute care hospital Business Office experience
Required Licensure and/or Certifications
None
Physical Requirements
Primarily works in a climate‑controlled area
Sitting 80% of time on duty
Tolerate repetitive arm and hand movements
Seniority level Not applicable
Employment type Full‑time
Job function Health Care Provider
Industries Hospitals and Health Care
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Brief Description Perform patient account follow-up, credit balance review and resolution, keeping the hospital's accounts receivable as accurate as possible.
Duties and Responsibilities
Insurance Follow-up, as assigned
Contact insurance carriers regarding outstanding balances until resolution
Resubmit bills to insurance carriers as needed
File insurance carrier appeals for payment and/or denial disputes
Validate accounts for accurate payments, discounts, and contractual adjustments
Reply to insurance carrier correspondence as appropriate
Answer incoming calls, resolving patient, insurance, and/or vendor issues timely
Patient Follow-up, as assigned
Contact patients regarding outstanding balances until accounts receivable resolution
Validate bills for accurate discounts and contractual adjustments
Set up payment plans and monitor until resolution
Refer uninsured accounts to Pre-Collection
Assign patient accounts to Bad Debt when appropriate
Communicate with TPL agencies and attorneys
Process bankruptcy notifications
Review charity care applications and refer to the Director, or Collection Supervisor, for approval or denial
Credit Balance, Physician Payment, Trauma Billing, Client Billing, and Miscellaneous Reports Processing, as assigned
Process refund requests for patients and insurance carriers
Process uninsured claims for specialty physicians
Track and trend Medicare Bad Debt assignments for the Cost Report
Research unidentified checks for posting corrections
Non‑Essential Duties
Cancel Medicare and Medi‑Cal eligible accounts from collection agencies, as assigned
Assist with other duties as assigned, within skill sets and abilities
Knowledge
Working knowledge of HMO, PPO, Commercial, Medicare HMO, Medi‑Cal HMO, Government, and Workers' Compensation reimbursement
Working knowledge of Managed Care contract language and interpretation
Working knowledge of Microsoft Office applications
Knowledge of basic arithmetic
Skills
Proficient in basic personal computer
Proficient in the use of a calculator
Proficient in the operation of scanners, copiers, and fax machines
Abilities
Ability to handle stress
Ability to manage a heavy caseload in an organized and efficient manner
Ability to recommend appropriate account adjustment and write‑off suggestions
Ability to recognize potential accounts receivable related problems and offer solutions to management
Ability to maintain a working relationship with other departments within the organization
Ability to review all billing transactions for accuracy, discrepancies, and appropriate charges
Ability to document account information at time of account follow‑upAbility to run accounts receivable reports as needed
AVH Values
Patients Come First – We listen actively and communicate with our patients and families, placing safety as a top priority.
Accountability & Ownership – We fully complete tasks, are transparent, effectively communicate, and recognize that what we do reflects on us.
Teamwork – We build trusting relationships, promote a sense of community, and are respectful of everyone. Success is about the whole team.
Integrity & Honesty – We tell the truth at all times, speak up when something is wrong, and do the right thing when no one is looking.
Excellence – We take pride in our work, are goal‑oriented, and on a never‑ending quest for top tier quality.
Initiative & Innovation – Our can‑do attitudes, creativity, and resourcefulness empower us to improve the patient’s experience, solve our own problems, make timely decisions, and look for opportunities to add value.
Tenderness & Compassion – We have genuine empathy, show kindness, and encourage and advocate for each other.
Education
High School graduate or equivalent
Experience
Minimum 1‑year previous Commercial, HMO, PPO, Medicare HMO, Medi‑Cal HMO, Government, and Workers' Compensation billing and Insurance follow‑up experience
Will consider 2‑years’ recent acute care hospital Business Office experience
Required Licensure and/or Certifications
None
Physical Requirements
Primarily works in a climate‑controlled area
Sitting 80% of time on duty
Tolerate repetitive arm and hand movements
Seniority level Not applicable
Employment type Full‑time
Job function Health Care Provider
Industries Hospitals and Health Care
#J-18808-Ljbffr