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Patient Accounts Clerk

Salary: $14.15-$17.28 hourly / $2,462-$3,005 monthly / Range: 4646

DEFINITION: Under general supervision, computes, bills, posts, and collects patient accounts; and performs related duties as required.

DISTINGUISHING CHARACTERISTICS: This classification is distinguished from Patient Representative by the greater emphasis on collection responsibility, and by the absence of admitting duties other than on an occasional basis. Adequate performance at this level requires initiative in assembling data, mature decision making in analyzing facts, and enterprise in collecting accounts or in negotiating settlements.

EXAMPLES OF DUTIES:

1. Provides liaison between the providers of health care services, the patient, or other responsible persons, and revenue sources, to ensure the correctness of charges, a current record of all transactions, and account resolution.
2. Verifies health care charges against established rates for diagnosis, treatment, services, and supplies; may maintain patient accounts via an automated billing system, using codes to facilitate reimbursement from governmental and commercial insurers; and establishes pro-rata responsibility to permit prompt collection of patient's share.
3. Collects medical and patient data such as diagnosis, treatment, proof of eligibility, and insurance verification; submits claims to a wide variety of payment sources, including Medi-Cal, Medicare, and other third-party reimbursers; and prepares correspondence for collection of accounts.
4. Maintains active communications with patient and third-party carriers until account is paid or referred to other appropriate agency for further collection activity.

EMPLOYMENT STANDARDS:

1. One year of general office experience involving public contact in a medical office; or,
2. a combination of training, education, and experience that is equivalent to the employment standard listed above and that provides the required knowledge and abilities.

Knowledge of: medical terminology utilized in medical billing; current office practices and procedures; and basic math.

Ability to: elicit and evaluate information, sometimes of a highly personal and sensitive nature from a broad spectrum of individuals and agencies; maintain confidentiality; read, interpret, and apply regulations, policies, and procedures; work with minimal supervision and with extensive detail; prepare written correspondence using correct grammar, punctuation and spelling; coordinate functions and work cooperatively with others; touch type; use and access database computer applications; and organize work and set priorities to meet deadlines.

DESIRABLE QUALIFICATIONS:

Knowledge of: Current Procedure Codes (CPT) and International Class of Diseases Codes (ICD9) utilized in medical billing; fiscal record keeping using an automated system and/or health care billing including Medi-Cal, Medicare, or other third-party reimbursers; various public and private sources of assistance, and methods for qualifying for funding; collection laws, regulations, and techniques.

Ability to: convince debtors of the necessity of assuming financial responsibility, and explain the financial impact of various alternatives.



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