Howard University Hospital | Washington, DC

    Patient Accounts Representative II

    Job Title
    Patient Accounts Representative II
    Job ID
    27623039
    Location
    Washington,  DC 20060
    Other Location
    Description

    With over 150 years of caring for our community and each other in the Washington DC area, Howard University Hospital has a world-renowned reputation for high-quality, patient-centric care. Howard University Hospital is the nation’s only teaching hospital located on the campus of a Historically Black University and has created a superior learning environment, with groundbreaking research and positive patient outcomes.
     
    Howard University Hospital seeks to hire a Patient Account Representative II who will embrace our reach and historic tradition of excellence. If you want to make a difference in someone’s life every day, consider a position with a team of professionals who are doing just that, making a difference. 

    The Patient Account Representative: 

    • Verifies insurance coverage, benefits and calculating financial obligation for the provision of providing financial counseling to patients.
    • Enters/updates patient, insurance, contract, revenue, and/or reimbursement data into one or more applications.
    • Prepares and submits hard-copy billing claim packages, including collecting of all necessary materials for proper claim creation/modification; making payor-specific data changes as required for accurate and timely billing.
    • Prepares and submits specialty billing claim packages, including collecting of all necessary materials for proper claim creation/modification; making payor-specific data changes as required for accurate and timely billing; then monitors subsequent payor processing and reimbursement performance to ensure agreement/contract compliance. (Specialty billing includes but is not limited to: chemotherapy, research grants, special programs, and secondary/tertiary health plan.)
    • Monitors subsequent payor processing and reimbursement performance to ensure agreement/contract compliance.
    • Effectively collaborates through verbal and written forms of communication with patients and/or their family members, third-party payers, or attorneys on matters involving billing and the pursuit of payment for services rendered.
    • Utilizes HUH payer contracts to effectively & efficiently calculate expected reimbursements.
    • Performs routine arithmetic calculations associated with revenue billing, computing expected payor and patient reimbursement amounts, as well as contractual adjustment amounts for individual accounts.
    • Establishes and/or monitors self-pay financial plans; working with vendors as necessary where patients may qualify for financial assistance.
    • Collaborates with Clinical Care or Social Work to obtain necessary materials for accurate and timely billing; or for the purpose of supporting denial prevention & management team. Performs all necessary claim review and research to prevent claim delay as required for accurate and timely billing.
    • Reviews claims having incorrect or missing patient data, facilitates in the correction/addition of missing account data for the purpose of submitting an accurate and timely claim; subsequently initiates and follows through on remedial actions with supervisor to develop solutions that prevent future occurrences when errors are identified as being chronic.
    • Review and correct claim errors occurring on electronic claim scrubber system as defined by departmental guidelines; Monitor error frequency with immediate supervisor as remedial actions are developed and executed with error’s root cause.
    • Reviews and corrects all necessary items reflected in electronic billing/rejection reports or online claim status query results, delaying a third-party payor’s processing of claim(s); Subsequently initiates and follows through on remedial actions with supervisor to develop solutions that prevent future occurrences when errors are identified as being chronic.
    • Reviews and resolves credit balances accurately; Monitoring and reporting to immediate supervisors concerns with out-of-the-ordinary circumstances for investigation.
    • Performs payor remittance to reimbursement posting reconciliation and reimbursement posting corrections; ensuring reimbursement consistent with payor contractual/agreement terms before performing adjustments and/or billing of patient responsibility.
    • Performs manual posting of payments and necessary research when electronic posting is not applicable. (i.e. lockbox, payment posting batch failures, unidentified payments.)
    • Receives and responds timely to internal/external phone calls, correspondence, and inquiries related to patient accounts.
    • Performs internal/external phone calls, drafts correspondence, and makes inquiries related to account(s) as required for accurate and timely billing.
    • Prepares and maintains supportive data and documents on all required activities within hospital system as defined by departmental guidelines.
    • Promotes adherence to the Health Sciences Compliance Program, the Howard University Code of Ethics, and the Health Sciences Standards of Conduct.
    • Attends annual and periodic mandatory Compliance Program training including the Health Insurance Portability and Accountability Act (HIPAA) Privacy training.
    • Participates in activities that promote adherence to federal healthcare program requirements.
    • Actively participates in Health Sciences Compliance Program activities.
    • Adheres to the requirements of the HIPAA Privacy Policies and Procedures.
    • Maintains confidentiality of patients, families, and staff.
    • Ability to establish and maintain effective and harmonious work relationships with staff, physicians, Hospital and University officials, and the general public.
    • The employee is expected to achieve appropriate Hospital performance and productivity standards as established.
    • The employee will perform other duties that further the customer service needs of the department, such as answering phones, greeting and escorting patients, and administrative and clerical duties upon demand.
    • Assumes other duties and responsibilities that are related and appropriate to the position and area.
    • The above responsibilities are a general description of the level and nature of the work assigned to this classification and are not to be considered as all-inclusive.
    Minimum Requirements: 
    • High School Diploma or General Equivalency Diploma (G.E.D.)
    • At least 5+ years of experience in billing and collections required
    • Acute Care Facility experience (IP Stay collection, DRG Reimbursement, Medicare & Medicaid payer experience) required
    • Experience hospital environment required
    • Ability to pass the Patient Financial Services Proficiency Test by 80% or more; OR Possess and retain throughout employment certification as a Certified Patient Account Representative – CPAR (HFMA) or Certified Revenue Cycle Specialist (CRCS-I (AAHAM)).

    At Howard University Hospital our job is to care for you. We do this by offering:

    • Work life balance
    • Recognition and rewards for professional expertise
    • Competitive, comprehensive benefit plans offered (including health, disability, vacation, sick leave, and 403B retirement plan)

    COVID-19 Vaccination 

    Howard University Hospital requires all external applicants to be fully vaccinated for COVID-19 before commencing employment.  External Applicants may be required to furnish proof of vaccination and, if offered, may elect to be vaccinated at a designated Howard University Hospital location. 

    Must be able to walk, sit, lift (12-25 lbs.), reach, handle, write, type, speak, hear, see (depth perception), calculate, compare and evaluate, for extended periods of time.​​​​​​

    Required Skills

    High School Diploma or General Equivalency Diploma (G.E.D.) Requires 2-3 years of experience in Hospital Billing and Collections environment; and should be able to pass the Patient Financial Services Proficiency Test by 80% or more; OR Possess and retain throughout employment certification as a Certified Patient Account Technician – CPAT (AAHAM), Certified Patient Account Representative – CPAR (HFMA), or Certified Revenue Cycle Specialist (CRCS)

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