Job Summary: The Patient Account Representative possesses knowledge of insurance regulations and medical necessity requirements in collaboration with Pre-Certification Services. Responsibilities include reviewing patient clinical accounts; assigning accurate ICD-10, CPT, and HCPCS codes; and demonstrating knowledge of medical billing units and calculations. Maintains detailed records while coordinating with medical billing and clinical teams to ensure compliance with healthcare regulations and organizational policies. Must possess strong business office and attention-to-detail skills, as well as effective communication abilities.Â
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Clerical and receptionist duties are required. Responsibilities include, but are not limited to coordinating patient scheduling, follow-up appointments, updating health records, and managing referrals, authorizations, and the Epic work queue. The Patient Account Specialist is expected to function within the scope of approved departmental and organizational policies, procedures, and applicable regulations.
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The Patient Account Representative will be assigned a 40-hour workweek, Monday through Friday, from 7:30 a.m. to 4:00 p.m. The position is also responsible for assisting with orientation, preceptorship, and oversight of personnel assigned to the unit. Must be able to work and interact in a professional, non-defensive manner with peers, physicians, administration, patients, and visitors. The position functions under the general supervision of the Clinic Administrator and Nurse Manager. Completion of all annual mandatory education requirements is a condition of employment and is the responsibility of the employee to complete in a timely manner.
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