Patient Account Representative II
PRIORITY SCREENING DATE: Thursday, September 16, 2021 at 11:59 pm for a guaranteed review. Application materials will be reviewed in an ongoing basis until positions are filled. Please allow up to (2) two weeks for processing of application materials. (Postmarks and faxes not accepted.) The eligible list established by this recruitment maybe used to fill current and future permanent or temporary vacancies as they arise. Exam# 21/80M02/09CR.
Natividad is currently seeking several permanent full time Patient Account Representative II's. Under general supervision, the incumbent performs the full range of duties, and may do so on a rotational or specialization basis of assignment. The Patient Account Representative II (PAR II) is responsible for preparing patient accounts to generate and issue patient bills for services. This position interviews patients, evaluates patient financial resources, establishes payment terms, performs collections and performs other related work as assigned.
Examples of Duties
SIGNIFICANT RESPONSIBILITIES OF THE POSITION
- Reviews, verifies, obtains and corrects patient financial status and payor source information, medical diagnosis, laboratory and other diagnostic services information, hospital/clinic services and supplies, applicable dates, required authorizations and certifications, signatures, and other information related to preparation and processing of patient bills, and eligibility for coverage
- Enters data into and operates a computerized patient account system
- Researches and resolves missing or conflicting information
- Interviews and works with patients, families, and others regarding financial resources, eligibility for coverage, status and basis of charges, payment requirements, payment plans, collections, and related matters, in person, by telephone and by letter
- Works with other service providers, claim adjudicators, insurance companies, private payors, governmental payor sources, the County Revenue Recovery Division, and others to obtain, correct or provide information; verify eligibility; process patient accounts; verify procedures; initiate collection and/or resolve disputed, unprocessed, and other claims requiring follow-up
- Assembles pre-billing materials; prepares, generates and sends individual, insurance, governmental, crossover, and other bills for medical care related services; evaluates, modifies and resubmits bills
- Evaluates and processes bad debt accounts; performs collection and follow-up activities; refers uncollectible accounts to collection services
- Requests completion of additional forms or information for denied claims or special processing requirements
- Reconciles accounts; posts payments; adjusts balances to reflect denials, adjustments, shares-of-cost, payments, and other modifications to balances; prepares refund packages for approval
- Reviews billing documentation; resolves issues that would prevent accurate, prompt claim billing
- Runs computerized reports to search for missing or conflicting information
- Troubleshoots download problems; communicates problems and recommendations to supervisor for approval
- May work in a specialty area such as pre-billing, billing, or collections
Examples of Experience/Education/Training
A combination of experience, education, and/or training which substantially demonstrates the following knowledge, skills and abilities:
Thorough knowledge of:
- Federally Qualified Health Center billing procedures and operations
- Insurance, other private workers compensation, governmental and special payor requirements, procedures, codes and forms
- Hospital/clinic billing procedures and operations
- Sources and eligibility requirements for publicly-funded medical care payment programs
Working knowledge of:
- Clerical bookkeeping practices and procedures.
- General Clerical Office Practices and procedures, including operation of common office equipment and filing systems
- Current Procedural Terminology and other reference and resource materials related to patient account activities
- CPT coding procedures
Some knowledge of:
- Basic Medical Terminology and/or medical billing operations.
- Personal Computer operations.
Skill and Ability to:
- Perform arithmetical computations, comparisons and postings rapidly and accurately.
- Perform data entry on a computer key board quickly and accurately
- Operate a 10 key adding machine quickly and accurately
- Accurately match and file materials using alphabetic and numeric systems.
- Read and apply complex procedures and regulations
- Establish and maintain effective working relationships with a variety of individuals under potentially hostile or emotional circumstances
- Assemble pre-billing packages and prepare bills
- Evaluate, determine and approve eligibility for specialized publicly-funded medical care payment programs
- Prepare medical billing for electronic billing submission.
- Evaluate patient payor sources; and follow-up on past due accounts
- Evaluate, determine and approve eligibility for specialized publicly-funded medical care payment programs.
- Operate a patient accounts computer system
- Evaluate patient financial status and payor sources, establish payment plans and follow-up and collect past due accounts
- Read and apply complex procedures and regulations
EXAMPLES OF EXPERIENCE/EDUCATION/TRAINING
The knowledge, skills and abilities listed above may be acquired through various types of experience, education or training, typically:
One (1) year of experience performing duties directly related to patient account billing, patient financial resources evaluation, account collection or assessment of patient eligibility for specialized medical care financial programs;
One (1) year of experience at a level equivalent to Monterey County's Account Clerk
Two (2) years of experience equivalent to Monterey County's Patient Account Representative I
CONDITIONS OF EMPLOYMENT
- Natividad requires that all incumbents pass a pre-employment physical/medical assessment.
- Natividad will conduct a thorough background and reference check process which includes a Department of Justice fingerprint check.
- Employees who drive on County business to carry out job related duties must possess a valid CA Driver License for the class vehicle driven and clean driving record.
- Employees must have and show their original Social Security Card and a valid CA Driver License or CA State ID prior to the first day of work.
- Incumbents may be required to work all shifts, including weekends and holidays;
- Incumbents may be required to work with potentially hazardous and infectious substances.
**REQUIRED APPLICATION MATERIALS AND SCREENING PROCESS**
The screening process is tentative. Should a change be made, applicants will be notified. The competitive process includes:
APPLICATION SUBMISSION: A completed Monterey County Application may be obtained from and submitted to the Natividad Human Resources Office, 1441 Constitution Blvd., Bldg. 300, Salinas, CA. 93906, or On-line applications may be submitted at www.natividad.com ; resume and license and/or certifications (if applicable) may be attached to your online application or emailed separately to: GarciadL@natividad.com . Resumes will be accepted in addition to, but not in lieu of the required application materials. For more information or to obtain regular paper application materials please contact the Natividad HR, 1441 Constitution Blvd.,(831) 783-2700, M - F, 7:30 a.m.- 5:00p.m.
QUALIFICATIONS APPRAISAL : All licenses/certificates will be verified via primary source. Completed application materials will be competitively evaluated. Please note: The initial screening for this position uses ONLY the applicant's answers to the Supplemental Questions. Screeners (who are Subject Matter Experts) are not given the application and/or resumes at this point in the process. Therefore, your answers to the Supplemental Questions are critical. The best-qualified applicants will be invited to participate further in the process.
QUALIFICATIONS ASSESSMENT : To further assess applicants' possession of required qualifications, this process may include an oral examination, pre-exam exercise, performance exam, or physical ability exam.
ELIGIBLE LIST : Applicants successful in the Qualifications Assessment process will be placed on an eligible list for possible final selection interview. This eligible list will be used to fill current and future vacancies.
- If you believe you possess a disability that would require test accommodation, please contact the HR Analyst for Natividad at (831) 783-2711.
- Employment is contingent upon acceptable documentation verifying identity and authorization for employment in the United States.
- If you are hired into this classification in a temporary position you will not be eligible for the benefits.