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Patient Account Representative Resume Samples
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0-5 years of experience
Managed Account Receivables for 40+ providers
- Maintained accurate and timely collections of balances to ensure a balanced deposit each day
- Communicated with patients, faculty, students, insurance companies and other departments to resolve patient accounts
- Resolved system reports such as aged accounts receivable and unallocated payments reports
- Answered patient questions, inquires and concerns regarding their accounts
- Trained new employees on all aspects of Patient Account Representative responsibilities
0-5 years of experience
Maintained all patient account balances within required time frame
- Monitored all delinquent accounts and managed collection activities
- Assisted to resolve billing issues for customers through regular inquiries
- Performed medical collection activities as per established guidelines
- Ensured compliance to HIPPA laws and federal regulations
- Administered credit balances for all patients and players
- Coordinated with customers to answer patient payment plans
0-5 years of experience
- Billed and collected Medi-Cal claims on UB92; contacted Insurance payers to facilitate efficient cash collections; appeals and follow up on all outstanding revenue over 45 days; reconciled accounts using EOB’s and processed adjustments when needed.
- Reduced aged A/R under 120 days in 3 months
- Increased Medi-Cal revenue by 40 % in 3 months
- Selected as staff trainer for Premis
0-5 years of experience
Using a telephone, collected payment from delinquent medical self-pay accounts.
- Arranged for payments to be made by debtors via telephone, sending statements to debtors, insurance companies, and attorneys in accordance with established policies and procedures.
- Worked with third party payers to ensure timely recovery of outstanding delinquent accounts.
- Following Federal and State regulations in a manner that ensured positive patient and client relations.
- Prepared and distributed patient billings on a weekly basis.
- Analyzed and discussed disputed patient accounts with senior management.
0-5 years of experience
Rebilled claims to either primary or secondary insurance companies.
- Appealed when necessary for underpayment and/or no pre-certificates and authorizations.
- Completed all related requests and correspondences from insurance companies.
- Assisted Self Pay team members in resolving patient’s account balances.
- Researched and responded to all insurance inquiries received by telephone, fax and mail.
- Updated patient’s insurance information and initiated account adjustments.
- Metrix, Epremis (Relay Health), Paragon, Med Assets (Contract Manager).
0-5 years of experience
Resolved complex patient account issues.
- Collect and follow up on all accounts assigned prior to, during, or after admission and discharge. Communicated financial policies to all patients.
- Verified, researched, and completed all paperwork to billed Medicare and Medicaid claims for reimbursement.
- Served as patient advocate during the entire cycle of the account through telephone, mail, and research efforts. Medicare Collector/Billing.
- Working reports for Credit balances, refunds, bad debt, and IME billing. Re-billed Inpatient/Outpatient claims, updated insurance information.
- Work (RTP) Return to provider claims and issues using resources and DDE/FSS Medicare/Medicaid GAMMIS system.
0-5 years of experience
Responsible for reviewing commercial and government insurance payments on hospital inpatient/outpatient (UB04) and professional fee (CMS 1500) claims utilizing Meditech software.
- Contact commercial and government payers regarding underpaid and denied claims as well as contacting patients regarding claim issues.
- Handle correspondence from insurance companies regarding billing questions, billing issues, and medical claim denials. Identify and correct any coordination of benefit problems identified on patient accounts.
- Process refund requests for insurance overpayments and patient overpayments and confirm claim underpayments/overpayments by analyzing the insurance explanation of payments and insurance contracts.
- Identify authorization, cash posting, and registration errors on patient accounts and route to the appropriate department for correction.
- Submit unbilled or corrected UB04 and CMS 1500 claims by utilizing Quadax/Xpeditor software.
0-5 years of experience
- Performed and facilitated claims processing with third party payors for coordination of benefits.
- Managed claim denials by contacting clinical department, patient, payor or fiscal intermediary by phone, email or appropriate website
- Initiated appeals on denied hospital claims requiring detailed research for claim resolution
- Communicated to and advised appropriate staff of changing payor policies, denial trends and policies
- Maintained patient accounting files requiring detailed notes, manual logs and on-line functions for submission to third party payors
- Assisted with claim edits.
6-10 years of experience
Mastered cardiology billing rules and utilized this knowledge to work aging accounts. Promoted to Medicare Team Leader position and was responsible for a team of four employees. Trained current staff and new hires in effectively working Medicare claims in this specialty.
- Followed up on unpaid claims for all insurance types.
- Set up patient accounts/encounter visits and entered charges for billing.
- Answered patient billing questions and addressed patient complaints.
0-5 years of experience
Managed electronic records, indexed, and managed workflow using BAR and LSS Document Management Systems.
- Facilitated release of information (ROI) and medical records requests to all Centura hospitals for fulfillment.
- Data entry to include attaching all electronic correspondence to patient accounts and notating accounts for further processing within internal Centura departments.
- Documented CHPG databases and Retail Lock Box queues when needed.
- Used knowledge of true technical denials, coordinated EOB’s.
0-5 years of experience
Primary connection between referral sources, physicians, and patients
- Gained patient information through data and observation
- Determined market strategies, performed sales calls and in-services
- Maintained patient and office relationships as a patient advocate
- Attended ‘face to face’ patient appointments
- Educated patients on Home Medical and Full Durable Medical Equipment
- Coordinating Referral requests and ensuring billing has necessary paperwork
0-5 years of experience
Resolve account balances to a zero dollar amount within the standards and procedures of client
- Provide secondary customer service to primary clients’ patients in attempt to remediate account issues
- Review contracts between client and insurance to insure facility is reimbursed per contracted rate
- Report contact disputes to client in order to have accounts resolved within timely limits
- Prepare and submit unbilled claims, corrected claims, claim reconsiderations, and provider appeals
- Maintain strictest confidentiality; adhere to all HIPPA guidelines/regulations
0-5 years of experience
Answer incoming patient phone calls with courtesy and helpfulness (80-100 daily calls).
- Resolve and reconcile incoming phone inquires efficiently and courteously in timely manner or create a backlog to be researched.
- Handle Commercial and Medicare INS patient’s inquiries, by clear oral or written communication in timely manner.
- Make necessary demographic additions, deletions and changes per oral or written requests.
- Follow acceptable procedures for invoices that are zero (0) to sixty (60) days old using the Paperless Collection System (as scheduled by your Patient Accounts Coordinator or Patient Accounts Supervisor.
- Reconcile credit balances and process valid refunds from the Daily Credit Report within seven (7) working days.
- Authority to write-off an invoice with reasonable proof and justification neither up to $2500.00 nor as directed by Patient Accounts Coordinator or Patient Accounts Representative.
- Attend weekly Dept meetings with questions and concerns.
0-5 years of experience
Received high volume incoming calls regarding patient account balances
- Provided additional services to existing customers regarding medical claims, payments, credits, complaints and charity care applications
- Recommended additional payment plan options that would fit client’s needs.
- Provided quality service to customers
- Completed Mentor Assist program; provide training to new employees
6-10 years of experience
Communicated with health insurance companies to verify patient enrollment and eligibility.
- Electronically submitted claims to insurance companies.
- Electronically downloaded payments from insurance companies and applied payments to patient accounts.
- Collected copayments from patients.
- Answered phones.
0-5 years of experience
Specialized in Medicare/ Managed Care and Commercial Billing & follow up to insure highest reimbursement with accurate documentation.
- Resolve billing problems and answer patient inquiries to keep accounts current.
- Daily and monthly A/R reporting and follow-up.
- Expert in Medical Billing & Reimbursement for both Professional and Technical billing, account auditing for accurate documentation.
- Manage all patient billing files.
- Assisted with daily and monthly reporting, file maintenance and special projects.
- Resolved billing problems using collection techniques to keep account receivables current.
0-5 years of experience
Accurately input/post payments and contractual adjustments to proper patient accounts.
- Answered patient billing inquiries; updated patient demographic information.
- Appropriately identified errors on denied/rejected claims to submit to billing department to be refiled.
- Perform other administrative duties: mail, phones and filing.
- Followed up on claims in the Centricity system and processed deposits remotely.
0-5 years of experience
- Managed front office, including handling heavy call load, checking in and admitting patients into Brotman Medical Center’s P-Bar system.
- Scheduled patients for main office and two satellite offices.
- Organized all patient charts for main office and two satellite offices.
- Verified and processed private and worker’s compensation patient insurance benefits, eligibility and authorization for main office and two satellite offices.
- Gathered information on all new patients for main office and two satellite offices, including information on reports, studies and films.
10+ years of experience
Have worked closely with the marketing manager for the past 6 years in developing and maintaining client relationships
- Work on getting CAMC Labworks more recognition in the area and some of the outlying areas
- Deal with client offices on a daily basis, handling any billing or patient issues that may have arisen
- Act as a liaison for CAMC Labworks to the rest of the divisions of CAMC
- Assist in the design and maintenance of the webpage
- Communicate on a daily basis with the other patient account departments of CAMC
- Utilize various software tools to assist patients concerning billings, problem resolution, and department referrals
0-5 years of experience
Resolved routine patient billing inquiries and trouble shoot problems.
- Daily insurance phone calls incoming and outgoing benefit verifications.
- Entered daily charges, checks, credit card, cash receipts, along with daily banking deposits and petty cash handling.
- Analyzed and coded surgical procedures and diagnoses using ICD-9 & CPT-4 codes.
- Demonstrated capacity to work under pressure and ability to multitask at all times on many different levels.
- Maintained annual coding meetings updates and good working knowledge of utilizing the IDX Billing Accounts Receivables applications, and Windows based software packages, including word processing, spreadsheets, databases, and electronic mail.
- Remained compliant with HIPPA guidelines and maintains the strictest confidential practice when dealing with patients’ personal and financial information.
- Trained co-workers to create strength with the proper entry for insurance card information, obtaining co-payments, and Financial Status Classification accuracy.
- Established leadership as an independent billing representative with the effort of restoring the confidence that every area of billing responsibilities would be carried out.
0-5 years of experience
Submitted all inpatient/outpatient insurance claims to insurance companies to process for payment
- Edited all claims with errors before resubmitting claims
- Filed all secondary claims with proper documentation within 2 days of primary insurance payment
- Provided follow-up and resolution on submitted claims
- Corresponded with insurance carriers for claim status and provided additional documentation to carrier when requested
- Updated patient claim status if pending information or denials/ appeals inappropriately denied claims
- Reviewed cash receipt and credit balance report daily and bimonthly; identified insurance or patient overpayment
- Provided quality customer service for all incoming patient, insurance carrier, and attorney calls, as well as internal calls according to HIPPA guidelines
- Provided follow-up on self-pay balance after insurance payments were posted
- Reviewed and responded to correspondence with 48 hours of receipt
10+ years of experience
- Maintained low accounts receivable (60-90 days).
- Performed insurance verifications and auditing for expectant reimbursements.
- Appeals, assigning diagnosis procedure codes using CPT/HCPCS coding.
- Handled and resolved patient concerns, insurance billing and crossover, adjustments on A/R accounts.
10+ years of experience
Communicate with customers to verify demographic and insurance information
- Generate electronic insurance verification
- Analyze hospital contracts
- Attain pre-certifications and referrals
- Demonstrated proven skill in the training of employees on collections with 97% increase in collected revenue.
0-5 years of experience
Received, interpreted, reviewed and accurately entered service requests using computer systems
- Provided customer service support over the telephone and electronically to meet customer needs
- Met company and customer deadlines
- Followed company rules and standards of procedures
0-5 years of experience
Work accounts through the complete revenue cycle for office and OIC (office infusion center) charges
- Transitioning the practice to a new PM (eCW)system
- Contact patients regarding outstanding balances (Send delinquent accounts to collection agency)
- Process insurance payments (refunds) to patient accounts
- Create and mail insurance claims and patient statements
- Extensive experience disputing denied insurance claims
0-5 years of experience
Billed accounts on 28 day cycles using Microsoft Word
- Followed up with Guarantor on delinquent accounts via phone calls and emails to ensure payment
- Provided detailed statements as per request of Guarantors for clinical, pharmacy and medical services for submission to insurance companies
- Kept record of all payments and transactions on patient accounts including ancillary expenses
- Entered in system all ancillary services and related costs for each patient account over and above clinical services
- Maintained financial records and valuables for each patient
- Dispensed petty cash to patients when requested
0-5 years of experience
Analyze all information provided on accounts to determine a course of action for account resolution.
- Use hospital system and other online tools to access UB’s, 1500’s, EOB’s, remits, medical records or other information as needed.
- Contact insurance companies to obtain claim status, re-bill or adjust claims as needed.
- Document hospital system and Inventory Management System (IMS) with appropriate notes and action taken for claim resolution.
- Abide by HIPAA regulations.
0-5 years of experience
Reviewed explanation of benefits for accuracy, and proper reimbursements of claims
- Coded laboratory charts, and submitted to insurance companies for billing
- Reviewed billing reports to identify denied, or rejected codes, made corrections and resubmitted for payment
- Contacted nursing homes, patients and insurance companies for outstanding balances
- Processed insurance/patient correspondence within 24-48 hours of receipt
0-5 years of experience
Protect the security of medical records to ensure that confidentiality is maintained.
- Review records for completeness, accuracy, and compliance with regulations.
- Answer the PARS line. This includes registering new patients, updating current patients demographics
- To ensure prompt patient care by scheduling and informing patient of their upcoming appointment.
- Contact patients who have requested MU Healthe. Verify their personal information and generate a new
- Verifying all visits is attached with the correct medical insurance.
0-5 years of experience
Identify patients and complete the registration process for Emergency Dept. Patients
- Responsible for obtaining financial and demographic information for maximum reimbursement.
- Verification of active Medicare, Medicaid, and Commercial Insurance coverage.
- Maintain scanned documentation in the Electronic ED Chart to include, Insurance Cards, Identification Cards, and other Medical Record documents
- Ensures signatures for General Consent are obtained.
- Distributes WakeMed’s Notice of Privacy Practices, Notice of Patient Rights/Responsibilities and Financial Policy
- Perform all duties and assignments promoting the Wake Way and supporting WakeMed’s Mission and Values.
0-5 years of experience
Identify problem accounts with payers; investigates and corrects errors, follows-up on missing account information, and resolves past-due accounts.
- Follow up with insurance companies to obtain payment in a timely manner
- Contacts responsible party to resolve delinquent accounts; prepares payment plans and monitors adherence to plans by responsible party.
- Document all calls, correspondence, and related activities to each patient’s account
- Obtain financial information from patients/guarantors to determine free care eligibility
- Answers inquiries by phone regarding past-due accounts and insurance guidelines; researches incorrect addresses for past-due accounts.
10+ years of experience
- Obtained financial clearance including benefits verification, documents for medical
- Investigated,followed up, and appealed unpaid accounts.
- Verified insurance, eligibility, and obtained authorizations when required.
- Counseled patients on financial issues including billing process and personal
- Initiated contacts and negotiated appropriate resolution both internal and external.
- Acted as liaison between patients, families, and the hospital staff
- Cultivated and maintained relationships with referral sources.
- Managed multiple tasks simultaneously and meet timelines.
6-10 years of experience
- Dealt effectively and independently with insurance companies to ensure proper payment according to the provider’s contractual agreement
- Communicated directly with other physicians and members as a liaison with regard to authorizations and verification of insurance policies
- Initiated face-to-face interactions with Provider Relations Representatives to resolve and/or negotiate escalated issues
- Proactively collaborated with University Hospital and its affiliates to make certain all documentation is received prior to patients treatment
0-5 years of experience
Correspond with both patients and insurance companies regarding billing issues
- Answer high volume calls, answer inbound calls on the Televox automated system
- Billed 1500 claim forms to appropriate insurance companies
- Verify insurance coverage, post payments, receive patient payments, respond to billing request from law offices and the state of Michigan
- Enter patient demographics, work directly with doctor’s and the medical facilities to resolve billing issues
- Actively utilize web-based software such as EMR, IDX (both web-based and character cell), CIS, WEB-Denis, and CHAMPS
- Work directly with insurance follow-up and coding areas on resolving payment issues
0-5 years of experience
Worked WC accounts based on Spread sheets, Agility Software, Image Now, Emails, Phone System collecting payment for outstanding invoices.
- Assisted in reviewing HICFA’s for accuracy, communicated with clinics, WC Carriers and Employer to ensure billings were correct for payment
- Submitted appeals, reconsiderations, and Fee Reviews for denial of payments
- Assisted in training new hires for their WC PAR positions, helping with procedures, and answering questions
- Assisted on Extra Projects when available
- Worked Employer Services Accounts submitting invoices and reminders on outstanding invoices following Spread sheets, Agility Software, Image Now, emails, phone system
10+ years of experience
Research complex reimbursement issues and medical benefits to ensure accurate payment of commercial, Medicare and workers compensation insurance claims
- Submit medical insurance claims for biopharmaceutical services
- Review and researches unpaid medical claims
- Maintain patient records by verifying patient demographics and current insurance data
- Interact with various insurance companies to ensure accurate coverage information
- Communicate daily with physicians, patients, and manufacturers
- Collect and prepare confidential healthcare patient data
0-5 years of experience
- Initially hired as Appointment Scheduler, moved to Patient
- Extensive telephone contact with patients and insurance
- Data Entry: IDX = Century Group Management
0-5 years of experience
Identify problem accounts with payers; investigates and corrects errors, follows-up on missing account information, and resolves past-due accounts.
- Follow up with insurance companies to obtain payment in a timely manner
- Contacts responsible party to resolve delinquent accounts; prepares payment plans and monitors adherence to plans by responsible party.
- Document all calls, correspondence, and related activities to each patient’s account
- Obtain financial information from patients/guarantors to determine free care eligibility
- Answers inquiries by phone regarding past-due accounts and insurance guidelines; researches incorrect addresses for past-due accounts.
- Post Payments to Insurance groups
0-5 years of experience
- Submitted claims to primary and secondary payors in accordance with payor
- Researched denials and unpaid claims.
- Prepared adjustments and write-offs for data entry.
- Scheduled/performed regular timely follow up telephone calls on all assigned accounts to both patients and insurance companies.
0-5 years of experience
Provides thorough and accurate collection of patient accounts. To provide support for various departments as needed in the attainment of stated goals. In addition, the Patient Account Representative will represent the hospital in all initial patient inquiries dealing with Patient Financial Services issues.
- Works assigned accounts daily in the PFS mainframe system providing thorough and accurate follow up. Productivity requirements are consistently met. Accounts are documented thoroughly and accurately.
- Works assigned denied accounts daily in the PFS mainframe system providing thorough and accurate follow up. Appeals are filed timely and accurately. Accounts are documented thoroughly and accurately.
- Responds to customer inquiries in a timely and courteous manner. Accounts are documented thoroughly and accurately.
- Reviews and processes correspondence daily. All correspondence is handled thoroughly and to completion.
- Stays updated on current billing practices and requirements for all insurance payers.
- Keeps patient financial services team leader and manager abreast of problem areas and helps identify solutions.
- Performs other duties as assigned to meet the organization’s needs
6-10 years of experience
Maintain complete and correct files of all insurance information and contracts
- Manage insurance changes and requirements
- Ensure current carrier information is maintained in the computer
- Managed billing and followed up with third party payers and patients for services
- Monitor accurateness, suitability and totality of patient accounts
- Followed up on accounts with outstanding balances in appropriate manner
0-5 years of experience
Patient Account Representative-billing claims, contact with patients and insurance companies for denied claims
- Maintenance of Collection Accounts; setting up payment arrangements; monitoring of patient payments from collections collected and reporting to Collection Agency, Researching criteria for Warning Collection letters.
- Opening of daily mail for Patient Accounting with distribution to appropriate departments
- Posting of third party insurance checks and patient’s payments
- Posting and working denials for Medicaid payments
- Working of denials for third party insurance payers
- Verification of insurance for patients
0-5 years of experience
Promptly answers, screens, and processes patients’ requests and telephone inquiries with strict adherence to confidentiality agreements and policies and procedures.
- Provides information on Provider Group Billing policies, and procedures.
- Collects and enters patient intake information into the appropriate area in EPIC. Documentation is to be concise, thorough, and accurate.
- Take thorough messages and effectively communicates such information to the appropriate claims specialist.
- Responds to irate callers in a professional manner.
- Supports organizational changes. Demonstrates flexibility in providing coverage and/or availability for the call center for unexpected absences, events, or call volume variance.
- Other duties and special projects that are assigned by management.
0-5 years of experience
Responsible for collecting and managing patient accounts receivable. Responsible for performing patient customer service, patient balance collections and patient accounts receivable review for accuracy of account balance.
- Identifies and resolves patient billing complaints.
- Answers questions from patients, clinic staff and insurance companies.
- Prepares, reviews and sends patients collection letters.
- Evaluates patient’s financial status and establishes budget payment plans.
- Performs various collection actions including contacting patients by phone.
10+ years of experience
- Comp rated UB04 and 1500 forms per the NYS Fee Schedule and sent to correct payer for prompt payment resolution
- Ensured that correct billing amounts were recorded
- Responded to client and patient inquiries
- Prepared MS Excel sheets for client showing adjustments to be made and prepared statements
- Created new accounts as needed
- Resolved patient problems
- Compiled transaction records using Debtmaster computer system
- Ensured proper recording and handling patient information
0-5 years of experience
Patient registration, insurance verification, processed correspondence, good customer service skills.
- A/R follow-up, Collection, resolved patient accounts & past due accounts on aging reports.
- F/U on payer status of unpaid claims, Knowledge of third party paper Regulations including Managed Care, Medicaid & Medicare.
- Called various insurance companies for pre-certification & authorizations, posted insurance & self pay payments, entered charges, processed refund, write-off/adjustments, appeals, denials & worked eob’s.
0-5 years of experience
- Assessment of outstanding balances on assigned accounts to determine proper course of action required to obtain payment on accounts.
- Contact insurance payers regarding outstanding account receivables. Follow-up on outstanding and delinquent accounts.
- Answer patient and/or insurance phone inquiries; utilize claims software to check status of claim, submission history and eligibility.
- Check claims to ensure proper ICD9/CPT coding and payor rules are followed. Post insurance payments and electronic remittances.
- Compose and type routine correspondence, memos, letters, etc.
6-10 years of experience
- Verification of patient information and insurance verification
- Knowledge of ICD-9 and CPT coding
- Process electronic and paper claims (HCFA CMS 1500 forms )
- Insurance collections, followed up on unpaid claims, and appealed denied claims when necessary.
- Patient collections and customer service
- General accounting worked with posting payments, adjustments and deposits.
0-5 years of experience
- Outpatient Charges for 8 physicians
- Posting of payments from insurance companies
- Review and appeal denials
- Patient phone calls and balances
- Reconciling weekly charges, payments, adjustments made to the system (closing of the week)
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Patient Account Representative
Last edited by: Gabriela Barcenas, CPRW, Content Writer II -
Gabriela Barcenas
CPRW, Content Writer IIGabriela is a Certified Professional Resume Writer (CPRW) and career adviser. With 10 years of digital media experience and five years of resume writing expertise, her publication history includes fashion, education, travel, social justice, equitable design and career advice.
