Patient Account Representative

Piedmont Cancer Institute is currently seeking qualified candidates to fill the position of Patient Account Representative (PAR)/Collector for our Central Business Office in Atlanta.

The PAR/Collector is responsible for conducting patient and insurance account collections as it relates to all aspects of A/R follow-up including, but not limited to, denial management, complete claim resolution, insurance follow-up, and patient balance collections. The successful candidate will be flexible and able to multi-task in a fast-paced, high-volume setting. Prior experience in a Healthcare/Managed Care environment is crucial for success in this role. This position is located at our Central Business Office in Atlanta and reports to the PAR/Collector Team Lead and Revenue Cycle Manager.

Primary Job Functions

• Conducts prompt and efficient collections efforts on all aging balances including patient and insurance A/R with an emphasis on decreasing A/R >90 days.
• Recognize and report on trending payment issues and denials and must be able to take the appropriate action to resolve such issues.
• Research and resolve denied and unpaid claims from various insurance companies using multiple resources such as payer websites, requesting telephonic reconsiderations, writing appeals, etc.
• Maintain knowledge of and ensure compliance with state and federal laws, regulations for Medicare, Medicaid, managed care and other third-party payers.
• Work with billing teams to solve difficult payment and associated department problems including claims processing and billing issues across the revenue cycle.
• Proactively participates in problem identification and coordinates resolutions between appropriate parties.
• Reviews and reports any missed revenue opportunities.
• Notifies Team Lead and Revenue Cycle Manager of any system, payer, or operation issue that affects daily collections and patient account functions.

Qualifications

• High school diploma (or equivalent) is required. Collegiate education preferred.
• Demonstrated knowledge of Healthcare reimbursement/collections, medical billing, CPT, HCPCs, and ICD10 coding, financial reporting, and management, with a strong knowledge of the collections process. Prior healthcare insurance follow-up/collections experience is a must.
• Advanced technical skills including PC and MS Excel
• Advanced knowledge of HCFA and Explanation of Benefits (EOB) interpretation
• Advanced knowledge of insurance billing, collections, and insurance terminology
• Oncology experience preferred, however, not required.
• Strong communications skills; ability to listen attentively and to communicate information clearly and effectively
• Customer service experience and the ability to work independently are required.
• Must be able to sit 8 hours/day. Work may be stressful at times. Exposed to general indoor working conditions.

Key Performance Indications

• 30 days DSO
A/R greater than 90 days — Percentage of long-term A/R of your total receivables -
• 12%
Denial rate — Percentage of total claims denied as a percentage of total claims submitted -
• 8 %
• Demonstrate timely collection efforts on all claims within assigned cope; working all claims at a minimum of once/month and high dollar accounts at least biweekly.
• Work an average of 40 accounts per day.
• Participate actively in weekly/monthly status discussions with the Collector Team Lead and Revenue Cycle Manager