EMS Patient Account Representative

EMS Patient Account Representative  (Spanish Bilingual - Required)

The EMS Patient Account Representative is responsible for working directly with the patients and their health insurance to resolve open balances.  This could include but not limited: utilizing payer portals to check claim status, updating patients’ insurance policy, reviewing / updating the ICD-10 code listed, working CMS1500, talking to attorneys and processing payments.

All representatives will conduct insurance verification as needed and are required to complete prebilling training to qualify for the role.

Responsibilities of the EMS Patient Account Representative

• Places and receives calls regarding billing insurance questions and other patient service activities.
• Process accounts according to the action required to resolve account balances.
• Comfortable communicating with any caller including customers, agencies, facilities, and hospitals.
• Employ one-step resolution practices for clients and patients through open lines of communication.
• Research patient accounts to verify all health insurance coverages.  Audit patient accounts to verify proper billing process was followed.
• Screen and professionally address emails, faxes, and other correspondence including mail.
• Ensure accuracy in data entry and consistent attention to detail.
• Collect outstanding balances as well as identify, address, and resolve account discrepancies while following company policy and procedures as well as billing policies and procedures.
• Demonstrates knowledge and compliance of insurance, local, state, and federal billing.
• Ability to complete tasks efficiently both individually and in a group environment.
• Handle assigned correspondence fulfilling any other duties as assigned by managerial staff.
• Must be able to scan and input information from hospital faxes to update accounts to be billed.
• Must be able to bill insurance by paper claims and follow all guidelines by individual payors.
• Must be able to review patient mail and attach documents to patient accounts with all verifiable information.

Qualifications of the EMS Patient Account Representative

• College preferred but not required.
• Minimum two years’ experience in customer care, account management or similar role.
• Ability to read and understand the Explanation of Benefits or Electronic Remittance Advice.
• Understands the difference between rejections and denials as well as working accounts.
• Healthcare knowledge is preferred.
• Must be a quick learner and motivated individual with excellent verbal communications skills.
• Fluency in Spancish is required. 
• Ability to “Multi-task” and manage spurs of high call volume
• Positive, can-do attitude and with good judgement demonstrating ability to de-escalate
• Ability to receive and implement feedback.

Computer and Office Qualifications of the EMS Patient Account Representative

• Computer literacy is a must; Typing skillset of at least 45 WPM minimum
• Experience working in an active office environment.
• Must be able to work with 2 monitors and split screens to operate multiple sites simultaneously.
• Must be able to sit / stand for 8 hours minimum in an office environment
• Must be able to use Word, Excel, Email, Chat Applications, workflow sites and other software applications.
• Must be able to read, comprehend, and apply job-related rules, policies, and procedures.