Patient Account Representative
The Patient Account Representative is a member of the Financial Services Department who is responsible for the accurate and timely data entry responsibilities in the Billing Department. Works collaboratively with members of other departments including management to ensure timely and accurate processes. Hours are Monday- Friday, 8:00 AM to 4:00 PM, with occasional Saturday mornings.
Description of Duties
- Process charges and claims accurately and timely to all payers in accordance with payer requirements and/or Rural Medical Services, Inc. policies.
- Responsible for timely follow up on insurance claim status, resolve denials/rejections, submit re-bills, re-submit claims, file appeals and resolve all front end/clearinghouse rejections in a timely manner.
- Serve as Patient Services Representative in accordance with written appointment and patient record policies, as needed and scheduled by the Patient Account Manager or CFO.
- Accurately and timely processing of all electronic remits (ERA) and manually post paper reimbursements.
- Ensure the balancing of payments and adjustments prior to posting each payment batch. Payments are posted timely.
- Query the clinical staff when code assignments are not clear to assure accurate and optimal code assignment for reimbursement.
- Alert Patient Account Manager regarding late or missing documentation required for billing.
- Responds to inquiries from insurance, patients, co-workers, clinical staff and providers promptly.
- Establishes and maintains a positive working relationship with patients, payers, co-workers and visitors.
- Maintains confidentiality of patient information and organization information at all times in compliance with HIPAA regulations.
- Works independently and as a member of a team with commitment to excellence while meeting deadlines under pressure while still delivering superior results.
- Alert the Patient Account Manager of any changes that impact the billing and Billing Department.
- Exercise excellent analytical skills and accurate attention to detail.
- Follow up on balances due from insurance companies and patients monthly.
- May be required to perform special financial and patient data studies as required by CFO or Patient Accounts Manager.
- Assist the Patient Accounts Manager with the training of Medical Receptionist Staff.
- Perform all clerical tasks as specified in clinic or office policies and/or as directed by the supervisor.
- Perform related tasks as directed by the Nurse Practitioner or Physician when at the Centers and Patient Account Manager.
- Keep medical records in accordance with the written medical records policy.
- Perform other duties as assigned.
Hours are Monday- Friday, 8:00 AM to 4:00 PM, with occasional Saturday mornings.
High School Diploma or Equivalent required.
One year of experience in a medical office working with insurance claims processing is preferred. Certified Professional Coder highly desirable.
Behavioral Health Provider / Psychologist / LCSW / Counselor
Provide behavioral health consultation to children, adolescents, adults, and families in order to improve psychosocial functioning. Must demonstrate respect for diversity and empathy for low-income populations and have a desire to improve their health status
Description of Duties
- Provide comprehensive assessment and diagnosis of behavioral health clients.
- Provide effective treatment planning and assist clients in successfully achieving goals.
- Evaluate crisis situations and apply appropriate interventions.
- Actively participate in meetings that support Rural Medical Services’ integrated health care model to provide comprehensive care for clients.
- Assist in the detection of “at risk” patients and development of plans to prevent further psychological or physical deterioration.
- Assist the primary care team in developing care management processes such as the use of guidelines, disease management techniques, case management, and patient education to improve self-management of chronic disease.
- Provide assessment, consultation, and brief intervention for psychological/psychiatric problems and/or disorders.
- Teach patients, families, and staff care, prevention, and treatment enhancement techniques.
- Monitor the site’s behavioral health program, identifying problems related to patient services, and making recommendations for improvement
- Other duties as required by Operations Director.
Masters Degree in Social Work or Doctoral Degree in Psychology (PhD or PsyD)
Licensed in the State of Tennessee as a Licensed Clinical Social Worker (LCSW) or Psychologist
Experience and/or Skills Required
- Working knowledge of behavioral medicine and evidence-based treatments for medical and mental health conditions.
- Ability to work through brief patient contacts as well as to make quick and accurate clinical assessments of mental and behavioral conditions.
- Should be comfortable with the pace of primary care, working with an interdisciplinary team, and have strong communication skills.
- Good knowledge of psychopharmacology.
- Ability to design and implement clinical pathways and protocols for treatment of selected chronic conditions.
- Bilingual Spanish/English preferred.
Rural Medical Services, Inc. complies with all applicable federal and state laws prohibiting discrimination in hiring or employment practices on the basis of citizenship, race, color, religion, gender, age, national and ethnic origin, disability, or veteran status. No question or item on this application for employment is intended to secure information to be used for such discrimination. Information obtained through this application will be used solely to determine qualifications and suitability for employment. Applications will be kept on file for 90 days.
Last Updated on February 22, 2021.