Patient Account Representative Jobs

Responsible for managing and performing efficient and effective AR functions for DCH Regional Medical Center, Northport Medical Center, Fayette Medical Center, DCH Home Health and Home Medical Equipment. Responsible for accurately and timely reviewing and correcting of all assigned claims in an error, hold, and or rejected status. Required to maintain individual and departmental goals for discharged not final bill submitted (DNFBS) claims, AR days, cash collections, AR Aging, and other goals as assigned.

• Ability to research and work assigned claims in an error, rejected,and/or hold status.
• Attends required training sessions and/or completes required certifications as requested by management.
• Makes lean recommendations to create process improvements.
• Bills assigned primary, secondary, tertiary, etc claims on a daily basis using Meditech, Optum, and other software programs utilized in the Patient Accounts Department.
• Maintain professionalism and create a positive customer service experience on all interactions.
• Responds to and works with other DCH departments (Patient Access, Case Management, Medical Records, etc.) to ensure efficient and compliant processes are in place for accurate revenue collection.
• Accountable for productivity to meet individual and departmental goals. (Final billed not submitted claims, AR days, cash collections, AR Aging, and other goals as assigned)

DCH Standards

• Maintains productivity and performance, patient and employee satisfaction and financial standards asoutlined in the performance evaluation.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Must adhere to the DCH Behavioral Standards including creating positive relationships withpatients/families, coworkers, colleagues and with self.
• All other duties as assigned.
• Performs compliance requirements as outlined in the Employee Handbook.
• Must adhere to DCH Health System policies and procedures.

High education or equivalent is required. One year or more of related experience in a Healthcare Business Office preferred. Knowledge of insurance types related to claims billing and follow-up such as governmental, HMO, PPO, Commercial, etc. preferred. Knowledge of federal, state, hospital, and departmental rules and regulations for compliant Healthcare claims filing and reimbursement preferred. Proficient in personal computer skills.Very good interpersonal/communication skills, customer service skills and history of good attendance required. Must be able to read, write legibly, speak, and comprehend English.

Working Conditions

WORK CONTEXT

Interpersonal relationships Job requires daily phone and/or face to face communication with co-workers and/or outside sources.

Physical work conditions Working indoors in a cubical area, sitting 80% of the time, standing 5%, kneeling 2.5%, squatting/crouching 2.5%, stooping 5%, and walking 5%. Activities include lifting of 35 lbs. maximum which would be a two (2) person lift, frequent lifting and/or carrying 20 lbs. Ability to push or pull over carpet floors, concrete ramps and on varied surfaces, a four wheel cart with 50 lb. of paperwork.

Filing ledgers or finding ledgers requires reaching, pushing, pulling, and extending the hands and arms in any direction. Stooping and bending the body forward by bending the spine at the waist. To reach lower areas requires kneeling by bending the legs at the knee or crouching by bending the body downward and/or forward by bending the legs and spine. This is 50% of daily work.

Organizing charts requires handling of papers by holding, grasping and turning, with picking up and pinching as finger movements. This is a repetitious procedure that is constantly being done.

Communication through talking, expressing or exchanging ideas by means of the spoken word. Hearing; perceiving the nature of sounds of the ear in order to communicate. Seeing; use of vision to determine characteristics of objects, depth perception, color vision with the ability to distinguish color, coding ledgers, near/far activity of 100% daily.

Mental Capability to maintain patient confidentiality 100% of the time.

Physical presence onsite is essential. Hearing and vision must be normal or corrected to within normal range. Able to perform the duties with or without reasonable accommodation.

Structural job characteristics Job requires 40 hours of repetitive work on desktop, per week.

PHYSICAL FACTORS

• The Americans with Disabilities Act (ADA) requires the job description to document physical factors, including ability, activities, and requirements.
• Hearing and vision must be normal or corrected to within normal range.
• Ability Must be able to sit for extended periods of time and lift boxes up to 20 pounds.
• Requirements Please indicate the physical requirements of the job as one of the following
• Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.
• Physical presence onsite is essential.
• Activities Job requires ability to communicate through spoken word, ability to use fingers for data entry
• Must be able to perform the duties with or without reasonable accommodation.

Other Job Factors

• Job requires being careful about detail and thorough in completing work tasks
• The ability to focus on a single source of sound in the presence of other distracting sounds
• Job requires being reliable, responsible, and dependable, and fulfilling obligations
• The ability to make fast, simple, repeated movements of the fingers, hands, and wrists
• The ability to shift back and forth between two or more activities or sources of information.
• Must be able to work well with others.
• The ability to tell when something is wrong. It does not involve solving the problem, only recognizing the problem.
• The ability to concentrate on a task over a period of time without being distracted.
• The ability to identify and understand the speech of another person
• Job requires a willingness to take on responsibilities and challenges
• The ability to remember information such as procedures.
• The ability to communicate in speaking so others will understand.
• Job requires being open to change (positive or negative)
• Must be able to work independently with little or no supervision.
• Job requires analyzing information and using logic to address work-related issues and problems
• The ability to speak clearly so others can understand you.
• Must be results oriented,
• The ability to understand information presented through spoken word or presented in writing.

The Team Leader functions as the unit-based clinical leader with responsibility for staff supervision, patient flow, patient safety, efficient resource utilization, mentoring of unit staff, especially recent hires, shift assignments and overall quality of care delivered. The Team Leader plans, coordinates and directs quality, compassionate care by maintaining standards of professional nursing practice and creating positive therapeutic relationships with patients/families. The Team Leader, under the supervision of the Nurse Manager, provides and coordinates in-services and continuing education programs for the clinical staff when indicated. Participates in PI activities; collects data to assess employee performance and participates in staff evaluation process. The Team Leader must be available to work weekends and holidays as per unit needs. Shifts may include 12hr and/or 8hr shift patterns with the goal of providing ongoing Team Leader support each day of the week.

The Team Leader is responsible for the following leadership and management duties

• Rounds with physicians.
• Performs initial and annual competency per job class.
• Assures compliance with policies and procedures
• Responsible for assessing and meeting own professional education needs.
• Promotes efficient patient flow including timely discharges and admissions.
• Maintains exemplary attendance and availability according to department need and rotates management duty.
• Manages performance
• Communicates information verbally and in writing to appropriate persons.
• Effectively implements current techniques and/or programs to improve patient care processes.
• Serves as clinical resource for staff, especially for new employees and during complex patient care situations.
• Provides direct patient care when needed.
• Ensures care is delivered appropriately by orienting staff in accordance with Standards of Practice, review of clinical record for appropriate documentation, and review of documentation of appropriate plan of care. Leads staff huddles to communicate important, “just in time” information to all staff on duty.
• Assesses, plans, implements, and evaluates programs for in-service and orientation.
• Maintains effective interdepartmental relationships by working with other unit leaders and departments to define and work toward common goals
• Regularly rounds on patients, physicians, and employees with focus on clinical safety, quality compliance, patient experience, satisfaction, physician and employee satisfaction and staff performance.
• Encourages a safe environment by promoting adherence to established protocols, policies and procedures.
• Assures compliance with various quality standards and regulatory agency requirements (The Joint Commission, CMS, Standards of Nursing Practice, PI process, value-based purchasing, Structural Indicators etc.)
• Coordinates unit activities and provides leadership for unit staffing and patient assignments and responds to and provides leadership during crisis and emergency situations.
• Consistently demonstrates the ability to utilize clinical data from Order/Entry/and PCI when collaborating with other health care professionals.
• Interviews, selects, hires, and retains employees
• Regularly prepares and presents staffing and outcomes metrics with action plans.
• Demonstrates knowledge of documentation and down-time procedures.
• Executes progressive discipline up to and including termination
• Displays sound judgment and critical thinking skills in areas of decision-making and problem-solving.
• Maintains records related to orientation in-service and unit competency assessments.
• Adheres to productivity, revenue and expense goals.
• Manages front line operations of area of accountability related to meeting/exceeding departmental goals, 5 keys of excellence, DCH Mission and Vision.
• Participates in PI programs.
• Directs activities toward support of DCH Mission and achievement of Department and Unit goals and objectives.
• Performs compliance requirements as outlined in the Employee Handbook
• Ensures orientation and training for employees
• Observes and practices DCH policy concerning patient confidentiality including on-line information and the Medical Record on file.

DCH Standards

• All other duties as assigned.
• Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self.
• Must adhere to all DCH Health System policies and procedures.
• Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Requires use of electronic mail, time and attendance software, learning management software and intranet.
• Performs compliance requirements as outlined in the Employee Handbook

Current Alabama RN license required. Anyone hired as of April 2016 or later, must have a Bachelor’s degree in Nursing or Healthcare Related Field or must be actively working on a Bachelor’s degree with completion within 4 years of hire. 2 years’ experience as a registered nurse required. Current American Heart Association (AHA) Basic Life Support (BLS) Provider, AHA Advanced Cardiac Life Support (ACLS), AHA Neonatal Resuscitation (NRP) training required. Customer service abilities including effective listening skills, critical thinking skills, decisive judgment and the ability to work with the minimal supervision in a fast paced environment. Must be able to read, write legibly, speak, and comprehend English.

WORK CONTEXT

• Communicate with different personalities and engage in face to face discussion
• Must be able to perform structured and unstructured work
• Includes possible exposure to human body fluids, disease, infection, lab chemicals and hazardous materials and/or cleaning solutions
• Demonstrate leadership skills
• Requires decision making that will affect others
• Must be able to use electronic mail, telephone and texting
• Requires wearing of common protective and safety equipment such as gloves, safety glasses, mask, gowns, etc.
• Ability to delegate to team members and students
• Address conflict and stressful situation
• Responsible to achieve outcomes
• Must be able to work in groups
• Must be meet time pressure and time lines
• Must be able to communicate clearly and accurately
• Dealing with unpleasant or physically aggressive personalities

PHYSICAL FACTORS

• Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.
• Must be able to tolerate prolonged periods of standing and walking
• Must be able to perform the duties with or without reasonable accommodation
• Must be able to stand, walk, kneel, bend, sit and stoop
• Must be able to move fingers in a coordinated manner and must be ablet o feel and perceive temperature, texture, shape and size with fingertips
• Must possess stamina to work prolonged shifts
• Physical presence onsite is essential.
• Hearing and vision must be normal or corrected to within normal range.
• Must have the ability to exert maximum muscle force to lift, push, pull and carry objects
• Must be able to run in an emergency
• Must be able to reach reasonable distances in any direction

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