Patient Financial Representative Resume Samples

Description :

1. Coordinate and maintain insurance and self-pay accounts to ensure accurate and timely payment.
2. Ensure adherence to established policies and procedures.
3. Performed billing, follow-up and customer service functions, field patient inquiries and maintaining departmental workflow.
4. Review and resolve accounts for correct balance.
5. Ensure maximum reimbursement and reduce denials related to incomplete insurance information and/or authorization.
6. Provided customer service to internal/external customers.
7. Learned and maintained the various Federal rules and regulations surrounding patient financial service companies and medical debt collection.
8. Utilized strong MS Office skills, including Excel, Word, and Outlook Employed proven skills in mathematics and financial analysis.

Experience

7-10 Years

Level

Management

Education

Business Administration

Description :

1. Conducts patient visits for bedside registration to expedite the completion of the patient registration.
2. Obtain and encode information into the patient management system of all pertinent demographic and insurance information.
3. Completes required forms and obtain appropriate signatures.
4. Performs pre-registration/registration processes, verifies insurance coverage and obtains authorizations and notifications.
5. Conducts patient visits for bedside registration to expedite the completion of the patient registration.
6. Responsible for answering and facilitating incoming patient calls to our Central Billing Office.
7. Provided support to billing team members involving claim management and other billing and collection processes.

Experience

2-5 Years

Level

Junior

Education

Certification

Description :

1. Coordinate communication between patients, family members, medical staff, administrative staff, or regulatory agencies.
2. Interview patients or their representatives to identify problems relating to care.
3. Maintain knowledge of community services and resources available to patients.
4. Refer patients to appropriate health care services or resources.
5. Investigate and direct patient inquiries or complaints to appropriate medical staff members and follow up to ensure satisfactory resolution.
6. Provide consultation or training to volunteers or staff on topics such as guest relations, patients' rights, and medical issues.
7. Develop and distribute newsletters, brochures, or other printed materials to share information with patients or medical staff.

Experience

7-10 Years

Level

Management

Education

Human Services

Description :

1. Verify insurance benefits for patients admission process upon arrival Having knowledge of governmental and managed care payer requirements.
2. Understands the data elements required to generate a clean bill.
3. Verified Insurance eligibility and obtains authorization for dates of service.
4. Implement policies and procedures for admission/registration of all patients.
5. Ensure appropriate time for posting payments and submit claims to obtain correct payments.
6. Create and modify documents such as invoices, reports, memos, letters, and financial statements.
7. Discussed outstanding balances with patients; set-up payment arrangements Collect co-pays Scheduled appointments.

Experience

7-10 Years

Level

Management

Education

HR

Description :

1. Responsible for Patient Registration and Insurance verifications.
2. In charge of balancing and maintaining petty cash as well as patient follow-up calls for next day procedures.
3. Evaluated insurance eligibility for patients to determine adjustments or reimbursements on patients' account; answered patient's inquiries regarding benefits and medical claims in a courteous and professional manner.
4. Accurately applied payments to patients account, and provided follow-up with insurance providers to ensure proper information and payments were fully collected.
5. Researched account receivables, and consulted with insurance companies to institute settlement agreements on patients account.
6. Maintained accurate up-to-date individual patient records and databases; answered multi-line phone system in a punctual manner.
7. Performed light clerical duties such as filing, faxing, and copying, as well as, processing large volume of correspondence on a timely basis.

Experience

2-5 Years

Level

Junior

Education

Associate Of Arts

Description :

1. Maintain physician's daily patient schedules Ensures same day add-on appointments is communicated to appropriate personnel departments and acquired authorization obtained.
2. Verifies insurance benefits and eligibility through HDX or other means when necessary and manually looking at patient's insurance card on a monthly's basis.
3. Verify type of insurance and identification of financial class.
4. Maintains and monitors the flow of front registration procedures and patients wait time in lobby to ensure timely patient processing.
5. Identifies deductibles, out- of - pocket expense, copayments, and percentage payables and facilitates the cash collection for services rendered to Cleveland clinic policy.
6. Schedules all follow-up appointments or special testing appointments using correct Epam/ Epic /Enterprise pathways and provides proper patient instructions.
7. Ensures appointments are booked on proper case and add any case or schemes as necessary.

Experience

5-7 Years

Level

Executive

Education

Associate Of Science

Description :

1. Works all assigned insurance payers to ensure proper reimbursement on patient accounts to expedite resolution.
2. Processes administrative, technical appeals, request refunds when applicable, reinstatements and rejections of insurance claims.
3. Ensures proper escalation is met when an account receivable is not collected in a timely manner.
4. Completes account follow up daily, maintaining established goal (s), and notifies Assistant Supervisor, when necessary, of issues preventing the achievement of such goal(s).
5. Ensures our corporate goals are met by consistently keeping our account receivables below our corporate standard.
6. Analyzes daily correspondence (denials, underpayments) to appropriately resolve issues.
7. Responds to written correspondence received from Payer and/or Patients.

Experience

2-5 Years

Level

Junior

Education

Administrative

Description :

1. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
2. Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.
3. Confirmed patient information, collected copays and verified insurance.
4. Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
5. Completed appeals and filed and submitted claims.
6. Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
7. Reviewed medical records for accuracy and completion as required by insurance companies.
8. Strictly followed all federal and state guidelines for release of information.

Experience

7-10 Years

Level

Consultant

Education

Finance

Description :

1. High preforming medical biller completing claims on a UB04 and UB92.
2. Primary trainer for new associates in the medical billing department on the Health Insurance Portability and Accountability Act (HIPAA), software and policies.
3. Audit billing invoices for inaccuracies and ensure compliance with insurance billing requirements.
4. Utilized consultative approach to define customer's needs and develop solutions that cultivated strong relationships with customers.
5. Exceeded quarterly collection goals by 20 percent equaling approximately 650,000 in accounts receivable.
6. Completed Medicare billing for lab charges.
7. Increased customer service satisfaction by providing solutions to financial constraints and qualifying customers for government assistance programs.
8. Explained billing invoices to customers providing necessary medical records and charge summaries.

Experience

10+ Years

Level

Senior

Education

Certification In Project Manager

Description :

1. Accurately and efficiently completed data entry and general reception deliverables in a timely manner at multiple hospitals and clinics throughout the greater Washington, DC area.
2. Clients included Prince Georges Hospital Center, Hebrew Home of Greater Washington, PG Hospital, Laurel Hospital and Bowie Health Care Center.
3. Performed data entry using 10-key and received patient payments by phone.
4. Addressed patient billing and insurance questions and inquiries, quickly resolving issues that arose.
5. Resolved issues and sent out electronic claims, processing refunds as needed.
6. Posted all insurance payments and prioritized workload to meet all established deadlines.
7. Utilized an array of software including Word, Excel, Adobe and Medical Billing databases.
8. Processed billing for skilled nursing facility services including Medicare Part A and secondary's.

Experience

2-5 Years

Level

Junior

Education

Bachelor Of Arts

Description :

1. Obtained working knowledge of all insurance payer's policies and procedures.
2. Researched claims denied for non-payment by resubmitting, appealing or processing applicable accounts for Bad Debt.
3. Ensured the patient received the assistance needed with any billing or claims issues.
4. Collected self-pay account balances, worked Accounts Receivable reports, reviewed Explanation of Benefits and helped patients establish payment plans.
5. Prepared Accounts Receivable adjustments for processing and approval.
6. Communicated with out of office certified medical coder, responsible for claims that were denied and in question, either by patient or insurance.
7. Preregister outpatients, update demographics, obtain auth before a visit, call insurance to obtain eligibility.

Experience

2-5 Years

Level

Junior

Education

Diploma

Description :

1. Scheduling patient appointments, canceling appointments and rescheduling patients, checking patients in and out for appointments.
2. Collecting co-pays (cash or credit card), insurance verification, entering new patient information, making new patient charts.
3. Obtaining prior authorizations for procedures from insurance companies.
4. Experienced in Medical Manager, experience in daily postings of charges and entering payments.
5. Very computer savvy, ability to make any forms with just a rough draft Preparing charts for the next day of business, getting messages to the proper person in a timely manner.
6. Experienced in the Medical Records Department, filing, pulling charts, copying patient records.
7. Experienced in using the ICD-9 book to look up codes for billing purposes Experienced in Accounts Payable.

Experience

2-5 Years

Level

Junior

Education

Diploma