Job Description

The Patient Account Representative (PAR) is responsible for working hospital/physician accounts to ensure they are resolved in a timely manner. A PAR will need to effectively perform (as applicable) charge reviews, retro-reviews, work account/claim edits in Cottage's EHR and follow-up on claim submission, remittance review for insurance collections, pursue disputed balances and resolve credit balances from both government and non-government entities. The PAR interfaces with internal revenue cycle departments and external payer organizations including Health Information Management, Case Management, review organizations, access/registration areas, and clinical departments
This is not an exhaustive statement of duties, responsibilities, or requirements. Employees will be required to perform any job, with related instruction given by their supervisor, subject to reasonable accommodation.

• Responsible for continued follow-up and collection of all asigned accounts that includes checking status via payor websites or systems and contacting the payer, physicians offices or the patient to obtain information necessary for claims processing and payment. Monitors accounts for timely filing guidelines and prioritizes work accordingly. (50%)
• Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership. Works and resolves HER edits daily, ensures claims are compliant, meet payer requirements, and billing errors/ claim rejections are resolved timely so that financial losses are minimized. (20%)
• Assesses payments and adjustments for accuracy and timeliness. Corrects transactions and transfers balances to responsible parties as necessary. Pursues underpayments and appeals denials made by insurances and refers service and/or payment denials to the appropriate revenue cycle department or vendor as necessary. (10%)
• Document clear and concise notes in the EHR regarding claim status and any actions taken on an account. Informs manager of problems identified that may lead to backlog status prior to backlog occurring. (5%)
• Reviews payments received and identifies billing or coding issues and request re-bills, secondary billing, or corrected bills as needed. (5%)
• Ensures compliance with State and Federal Laws Regulations for Managed Care and other Third Party Payors. (5%)
• Provide support/coverage for team members that may be absent or backlogged. Collaborates with internal departments, external vendors. Assists with tasks assigned by leadership such as special projects, testing, etc. (5%)

All job qualifications listed indicate the minimum level necessary to perform this job proficiently.

LEVEL OF EDUCATION
Preferred:

• Some College Coursework in accounting, business administration, healthcare administration, health information management or management

CERTIFICATIONS, LICENSES, REGISTRATIONS

TECHNICAL REQUIREMENTS

Minimum:

• Basic MS Word and Excel skills.35 wpm keyboarding/typing speed.Basic math skills.

Preferred:

• Advanced user of MS Word, Excel and Outlook.

KNOWLEDGE, SKILLS, and ABILITIES
All knowledge, skills, and abilities listed indicate the minimum level deemed necessary to perform this job proficiently.

• Ability to assess relevant information and make appropriate decisions, recognizing when to escalate to Supervisor/Manager for resolution.
• Strong interpersonal skills that reflect a positive attitude, with the ability to apply diplomacy and flexibility with patients and work associates, as required.
• The employee communicates effectively. The ability to communicate orally and through written correspondence with patients and third-party payors.
• Knowledge of collection procedures and basic medical terminology.

Cottage Health is a leading acute care hospital system, located on the central coast of California, widely known for our superior patient care, innovation, medical research and education. Our health system operates primarily in Santa Barbara, Ca, since 1888, and consists of three acute care hospitals, a Rehabilitation Hospital, multiple clinics and a multi-site Urgent Care system. Our mission is to serve the central coast communities with excellence, integrity, and compassion. Every day we touch thousands of lives in many different ways, resolute in our mission to put patients first. We take pride in helping our patients get back to living their lives - in the places they love.

Cottage Health is an Equal Opportunity Employer. Cottage Health applicants are considered solely based on their qualifications, without regard to race, color, ethnicity, religion, age, gender, transgender, gender expression and identity, national origin, ancestry, disability, sexual orientation, marital status, military status or any other classification protected by law. This policy applies to all aspects of the relationship between Cottage Health and an applicant or employee. Cottage Health is committed to upholding discrimination-free hiring practices. We strive to cultivate an environment where exceptional people bring diverse perspectives and find belonging, support and connection to their work.
Any Cottage Health applicants who require assistance or reasonable accommodations during the application process may request the need for accommodation with the Recruiter.
If you're already a Cottage Health employee, please apply on this link only.