Job Description

Overview

Patient Account Representative, Kingston Family Practice

Full Time, 80 Hours Per Pay Period, Day Shift

Covenant Medical Group Overview:

Covenant Medical Group is the employed and managed medical practice organization of Covenant Health, providing comprehensive care across East Tennessee. With more than 300 physicians and advanced practice providers in 20 communities, our team delivers expertise across a broad spectrum of specialties from primary care and walk-in clinics to preventive medicine and advanced surgical and subspecialty services. We are committed to offering coordinated, patient-centered care that spans the continuum of health needs, ensuring access to exceptional providers close to home.

Position Summary:

The Patient Account Rep II is responsible to provide timely and accurate follow-up of claim issues, working of accounts receivable and responding to inquiries from insurance carriers, patients, office managers and other staff. The Patient Account Rep II will respond to a minimum of 32 tasks per day or an equivalent work assignment, as well as other daily duties as assigned. This is contingent upon which functional area within the Business Office the position is assigned. The Patient Account Rep II serves as a resource to Patient Account Rep I’s by providing training and assistance with more complex issues.

There are several sub-categories of the Patient Account Rep II position that are used as internal designations, examples of the designations would be: Financial Poster, Accounts Receivables, Collections and Audit Response Rep. There may be variations within these designations as to specific responsibilities, related primarily to the customer base being served and the functional area within the Physician Central Business Office.

Responsibilities

• Understands Patient Accounts/Customer Service process including HIPAA policy regarding patient confidentiality guidelines.
• Understands and interprets billing procedures relative to account resolution.
• Exhibits the ability to handle assigned tasks from supervisor.
• Demonstrates knowledge of State and Federal regulations, HCFA guidelines, TennCare guidelines and other Third Party Payor requirements assuring departmental compliance.
• Communicates effectively with patients/public, co-workers, physicians and or their offices, and other office personnel using verbal, nonverbal and written communication skills
• Handles incoming telephone inquiries on assigned patient accounts in compliance with the CMG policies.
• Recognizes situations, which necessitate supervision and guidance, seeks appropriate resources after complete review of claim issue when all resources are executed
• Demonstrates good judgment when handling financial discussions with patients, maintaining a professional and confidential environment.
• Interprets and explains to patients and their families’ charges, services, insurance coverage, financial application guidelines and office policy regarding payment of their bills.
• Handles all correspondence relating to assigned patient accounts within five working days of receipt of task and/or denial of claim.
• Consults and works collaboratively with Supervisors, Co-workers, Managers, Department Director, and other office personnel, effectively performing assigned task timely and accurately.
• Promotes positive public relations for the physician CBO and clinics adhering to desired behaviors.
• Attends in services and other meetings as required to enhance professional growth and development. Completes all required CovLearn assignments timely on CovNet.
• Provides assistance to new employees with questions and training.
• Demonstrates promptness in reporting for and completing work-ensuring follow-through on assigned tasks.
• Demonstrates appropriate utilization of resources, i.e. equipment and supplies.
• Does not promote or participate in solicitation during working hours within the department.
• Performs other duties as assigned or requested.
• Serves as a resource for the Patient Account Rep I position by assisting in resolution of complex issues, seeking guidance from appropriate supervisory staff as needed.

Qualifications

Minimum Education:

None specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED. Preference may be given to individuals possessing a HS diploma or GED.

Minimum Experience:

Preference given to candidates with physician office experience. One to two (1-2) years of experience in Physician Billing, Business Office or Patient Accounts/Customer Service is required. Must meet all requirements of Patient Account Rep I position. Expected to perform adequately within the position after working at least 90 days on the job.

Licensure Requirement:

None