Patient Accounts Representative

CLASSIFICATION/STATUS: Non-Exempt, Full Time

IMMEDIATE SUPERVISOR: Patient Accounts Manager

SUPERVISORY RESPONSIBILITIES: None

FLEXIBLE WORK: Hybrid schedule option

PAY RANGE: Band 2($18-$25/hour)

WHO YOU ARE:

YOUR ROLE & IMPACT

The mission of Charles River Community Health (CRCH) is to partner with individuals and families so they can thrive and lead healthier lives by delivering the comprehensive, integrated, and equitable primary healthcare that matters most to them. The Patient Accounts Representative will play a critical role in the seamless administration of patient accounts. The Patient Accounts Representative will be responsible for following perform charge processing, payment processing, denial posting, insurance claims billing, and payment processing.

YOUR RESPONSIBILITIES

• Process and reconcile 835 files.
• Reconcile reimbursement checks with claims submitted.
• Collect and account for cash and other payments received.
• Follow up on insurance denials and takes appropriate steps to resolve discrepancies.
• Input insurance billing information processes EOB's, rejections, and re-billings.
• Understand account adjustments, corrections and write-offs to bad debt and free care and input same into system.
• Understand set up of accounts receivable system in such areas as insurance carriers, claim forms, and service codes. Inform Patient Accounts Manager of issues or changes needed.
• Run insurance A/R reports and investigate status of outstanding claims.
• Review and track encounter forms produced from the health center’s electronic record system.
• Approve and post encounter forms into the health center’s billing system including service codes, fees, insurance billing information, patient co-payments, and supporting data for the generation of claims to third party payers.
• Work collaboratively with providers to correct incomplete and/or incorrect service and/or diagnosis codes and ensure electronic record documentation is complete for billing purposes.
• Prepare and process patient bills and third party claims.
• Communicate discrepancies and the need for additional information to the appropriate parties.
• Answer billing questions for patients.
• Answer staff questions related to more complicated payment and claims processing situations.
• Maintain patient confidentiality when discussing information regarding patient bills.
• Work collaboratively with other Health Center staff in meeting JCAHO accreditation and other regulatory and/or funding requirements.
• Perform other departmental support duties such as telephone answering and filing.

YOUR QUALIFICATIONS, COMPETENCIES, TRAITS

• Three years of medical billing experience, preferably in a multi-service of FQHC environment.
• Understanding of the third party billing cycle and third party payer reimbursement rules, methodologies, and adjudication systems.
• Demonstrated understanding of and proficiency with the functionality of practice management and billing software systems/applications.
• Knowledge and experience with NextGen and Epic preferred.
• Bilingual in Spanish and/or Portuguese strongly preferred.
• Demonstrated ability to effectively communicate, collaborate, and problem solve across multiple functional areas and departments.
• Demonstrated proficiency in using Word and Excel at an intermediate level.
• Proven commitment to providing patients with exceptional customer service, with dignity, respect, and compassion.
• Commitment to our mission of reducing cultural, financial, and linguistic barriers to care and eliminating health care disparities for low income and underserved populations in our community.
• High school graduate or certificate program in third party billing.

WHO WE ARE & WHAT WE DO

Charles River Community Health’s mission is to partner with individuals and families so they can thrive and lead healthier lives by delivering the comprehensive, integrated, and equitable primary healthcare that matters most to them.

CRCH is a comprehensive practice providing medical, pharmacy, dental, behavioral health, optical, and vision services to diverse underserved local communities. We serve over 13,500 patients annually, and 90% of those served are low income, while over 70% need services in a language other than English.

We are committed to providing patients with timely access to the right care, at the right place and at the right time, collaborating with other organizations to connect patients with a comprehensive range of services and provide continuity of care, and creating new community partnerships to meet the changing needs of patients and the community.

We value caring for everyone with dignity, respect, and compassion, reducing cultural, financial and other barriers to care, and eliminating health care disparities for our patients. We also advocate for the needs of our patients, the community, and public health causes.

OUR PROMISE

If you are passionate about providing access to quality and compassionate care to the underserved, you will find your career rewarding and impactful. As Patient Accounts Representative, you will be part of a dynamic and fast-paced team with a shared vision to break down barriers in delivering healthcare excellence!

OUR BENEFITS & PERKS

• Medical, Vision & Dental Insurance
• Short & Long-term Disability , and Life Insurance
• Generous Paid Time Off
• Flexible Spending Account
• Employee Assistance Program
• Tickets at Work
• Health Reimbursement Arrangement
• Travel Reimbursement
• Professional Development Opportunities
• Solid track record of developing and promoting employees internally!

Charles River Community Health is strongly committed to diversity and a workplace environment that respects, appreciates and values employee differences and similarities. By providing and supporting a work culture that fosters and builds upon diversity and its strengths, CRCH will better serve our local communities and continue to provide quality patient care and services. CRCH is an employment at-will organization and an equal opportunity employer committed to maintaining a work and learning environment free from discrimination on the basis of sex, race, color, religion, national origin, pregnancy, gender identity, sexual orientation, marital/civil union status, ancestry, place of birth, age, citizenship status, veteran status, political affiliation, genetic information or disability, as defined and required by state and federal laws. Additionally, CRCH prohibits retaliation against an applicant or employee because he or she has engaged in protected activity under the statutes prohibiting discrimination in the workplace.