Staff Job Composite
Patient Relations Representative
Job Summary: Under general direction, responds to patients and insurance
company inquiries, questions, and concerns regarding registration, billing, and
collection; analyzes data; prepares reports; compiles financial statements; determines
patients financial status; serves as a liaison between medical and support staff for
billing and collections issues.
CHARACTERISTIC JOB TASKS AND RESPONSIBILITIES
May include any and/or all of the following:
- Responds to patient and insurance company inquiries regarding physician bills; reviews
patient account information; conducts insurance company inquiries; analyzes and interprets
account data; serves as a resource person for billing information to patients, insurance
companies, physicians, and office staff; posts demographic or financial entries on line;
documents action and posts comments on billing system; logs and monitors daily inquiries.
- Responds to patient/guarantor correspondence to resolve questions/concerns; provides
management with information and documentation; assists patients with concerns related to
registration, collection, and medication assistance; documents trends, concerns, and
issues; examines and interprets medical records.
- Prepares reports; compiles financial statements; performs financial assessments and
screening on uninsured or underinsured patients; establishes payment arrangements for
patients and communicates agreements; serves as a resource person to clinical departments
for debt status of patients.
- Serves as liaison between medical and support staff regarding billing and collection
issues and patients medical information.
- Researches and reviews data to ensure accuracy of accounts and balances; performs
special projects and other duties as assigned.
KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS
- Knowledge of University Medical Group policies and procedures
- Knowledge of patient accounting function
- Knowledge of Medicare/Medicaid billing and collection regulations
- Knowledge of HMO/PPO billing and collection procedures
- Decision-making skills
- Interpersonal/human relations skills
- Ability to maintain confidentiality
- Ability to work independently
- Ability to analyze and interpret account data
- Ability to maintain accuracy
Education and experience equivalent to:
Training equivalent to one (1) year beyond high school; supplemented with three (3)
years of previous related experience.