JOB TITLE:	Patient Accounts Representative III – Customer Service
REPORTS TO:	Business Office Manager
FLSA STATUS:	Non-exempt
JOB OVERVIEW:	Ensure a high level of customer service is maintained in the area of patient accounts including billing, collections and billing adjustments.

ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO:

1. Answer patient inquiries both by phone and in person regarding monthly statements or other billing/insurance issues.
2. Process changes in demographic and/or transaction information, insurance changes, charge adjustments, diagnosis updates, service date changes, etc.
3. Investigate and resolve credit balances on private accounts. Initiate refund requests according to clinic policies and procedures.
4. Maintain a working knowledge of the health plans with which The Doctors Clinic contracts. Identify internal and external resources to answer questions and resolve detailed problems.
5. Audit accounts for accuracy and resolve account discrepancies present by patient inquiry or colleagues.
6. Resubmit insurance claims per patient request or clinic Patient Accounts Rep.
7. Work with staff in the collections area to initiate payment plans with private pay patients to attain timely collection on all outstanding balances.
8. Collect patient payments providing patient with receipt.
9. Document patient complaints and forward to appropriate staff. Maintain log and review for systemic issues that need to be addressed by Manager for permanent correction.
10. Work with clinic site personnel to resolve patient account problems, both those identified by the patient and/or by the Patient Account Rep at the site.
11. Must have an understanding and/or basic knowledge of all the duties of the Patient Accounts I and II positions including the ability to perform the jobs if needed. May cross-train on the Patient Accounts III-Insurance Billing position.

ADDITIONAL RESPONSIBILITIES:

1. Provide leadership to the team on issues within own area of expertise.
2. Professionally represent the Clinic’s interests and patient concerns with staff at various health plans to resolve patient account issues.
3. Prioritize work received and complete in a timely manner.
4. Assist other office personnel in the performance of their duties as assigned and as workload permits.
5. Maintain confidentiality of sensitive information.
6. Work as a team member within the business office and all other departments in a collaborative, constructive manner.
7. Document work processes as required.
8. Perform other duties as assigned.

QUALIFICATIONS:

Education: High school diploma or equivalent.
Certification/Licensure: Not required.
Experience:
1. Minimum 3 years experience in customer service.
2. Minimum 2 years experience in medical billing practices.

Skills:
1. Ability to communicate in the English language in person, by phone and in writing in a clear, concise and professional manner.
2. Ability to resolve problems with minimal assistance.
3. Ability to utilize sound judgment in making and implementing corrective action.
4. Medical terminology required.
5. Basic computer and keyboarding skills.
6. Strong organizational and interpersonal skills.
7. Experience with conflict management.
8. Excellent verbal communication skills. Ability to independently write correspondence appropriate for mailing to patients and insurance companies or other third parties.

Other Requirements:
1. Ability to multi-task efficiently and effectively.
2. Must possess knowledge of coding and clinical operating policies and procedures.
3. Demonstrated experience and skills in providing customer service.
4. Must be able to act calmly and effectively in a busy or stressful situation.
5. Requires adherence to all policies and procedures, including standards for safety, attendance, punctuality and personal appearance.
6. Must be able to establish and maintain effective working relationships with managers and peers.

Physical Requirements:
HHearing: Adequate to perform job duties in person and over the telephone.
Speaking: Must be able to communicate clearly in person and over the telephone.
Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens for long periods of time without eye strain or stress.

Other: Requires sitting for extended periods of time. Requires manual dexterity to operate office equipment. Requires frequent bending, reaching, repetitive hand movements, standing, walking and squatting, with some lifting, pushing and pulling exerted regularly throughout a regular work shift.



THE DOCTORS CLINIC IS AN EQUAL OPPORTUNITY EMPLOYER

Last update: 5/16/2002

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