Patient Account Representative, Call Center Job

St. Paul, MN, 55101
Nov 09, 2012
Nov 26, 2012
Employment Status
Full Time
Patient Account Representative, Call Center

Job ID:: 24971
Department:: Patient Accounting GHI
City:: St. Paul, MN
Location:: HP - St Paul 180 East Fifth
Position Type:: Full-Time
Anticipated Work Schedule:: Monday through Friday, 9:00am-5:00pm
Hrs/Pay Period:: 75

Job Description::

The culture at HealthPartners is one of ownership, pride, service, and most importantly, partnership. That spirit of partnership among employees, and with patients and the community is just one of the many reasons we were recently named one of the nation’s “Best Places to Work in Healthcare” by Modern Healthcare magazine. Join us for a career that offers respect, support and encouragement. You’ll stay for the power of partnership.

Our continued growth has created an opportunity for a Call Center Patient Account Representative. Service excellence is to be centered on patient care and patient relationships and is the responsibility of all employees. Teamwork is the norm and all employees will be held accountable to work as effective team members. This position is the primary link with the customer involving research, resolving and providing responses to patients, members, prospective members, HP personnel and third party payers on wide variety of subjects, including billing, coverage and services provided at HP. This position is accountable for accurate and timely resolution of claims, to include denial management, follow-up and third party collections.

Monday through Friday, 9:00am to 5:00pm

HealthPartners 180 East Fifth Street Building in St. Paul, MN.



* Patient Accounting Terminology Test

* Data entry 4000

* 35 WPM


* High School Diploma or GED

* Three years recent experience, in a health care industry customer service/call center handling incoming and/or outgoing customer calls regarding medical billing and/or collection issues or two years recent medical billing and collection experience and one year general health care customer service experience

* One year experience with automated health care billing systems

* One year PC experience including Microsoft Word

* Knowledge of basic accounting principles

* Knowledge of insurance terminology, medical coding systems (ICD9 & CPT) and third-party billing and reimbursement procedures

* Good communication skills, written and verbal, to establish and maintain effective working relationships, with internal/external payers and customers

* Ability to work and make decisions independently, perform under deadlines and assume responsibility for problems and problem resolution

* Must be detail oriented and have the ability to organize information

* Must possess strong analytical and quantitative skills

* Flexibility - must be able to perform team duties as required to accomplish departmental goals and meet patient customer needs

* Ability to work well under pressure

Working knowledge of the following medical systems: DEC, Resolute (EPIC), & Medipac.
Working knowledge of billing and reimbursement policies of two or more insurance payors.

Ability to see (vision). Normal manual dexterity. Must be able to speak, read, and write English fluently. Ability to sit for prolonged periods of time.


1. Responsible for billing follow up/collection on assigned accounts with appropriate payers (i.e. governmental agencies, attorneys, patients, insurance companies) to ensure an acceptable level of outstanding receivables as defined by corporate or department key process measures based on national standards.

2. Investigate and respond to all phone and written inquiries from patient/member, third party payers, and attorneys concerning billing, account status, claim status and eligibility issues.

3. Accountable for ensuring an acceptable level of outstanding accounts receivable, as defined by corporate or department key process measures based on national standards.

4. Access and understand necessary information via automated membership files, claims inquiry, account histories, account status screens. This includes understanding the systems adjudication process in determining how a claim has been paid.

5. Perform maintenance as needed on the patient's insurance record to ensure accurate billing.

6. Demonstrating working knowledge of online payor systems (e.g AccessBlue, ProviderLink, Preferred One, Choice Plus, Medipac, & HCSS) in order to view eligibility and claim information on behalf of HPMG patients.

7. Interfaces with and responds to internal departments (i.e. Member Services, Claims, and HP clinics) as an information resource on billing documents (i.e. HCFA 1500 forms, Patient Statements ) for Fee for Service, Workers Compensation, Medicare, Medicaid, Coordination of Benefits, Third Party, No Fault, Reciprocity, Self-Insured, Pharmacy, Occupational Health as well as products provided and administered by HP and its subsidiaries.

8. Responsible for screening and appropriately routing misdirected patient phone calls regarding insurance benefits (i.e. copayments, deductibles, coinsurance) ,claim status (i.e. HP member services, Riverview Center, KVI, BCBS, etc.), and other inquiries not supported by Patient Accounting.

9. Receives, verifies, and documents patients over the phone credit card payment requests according to department procedures.

10. As needed, will negotiate suitable payment arrangement plans for individuals who cannot pay according to established guidelines and documents agreement according to department procedure. Accurately notes all action taken on patient's account in computer system.

11. Work with appropriate department/clinic/administrative staff to resolve questions and/or issues related to billing, coding and denials.

12. Resolve walk-in patient/customer questions as necessary in a professional manner according to department procedures.

13. Responsible for the understanding of insurance sequencing rules and medical billing guidelines or laws.

14. Documents accounts worked according to departmental procedures.

15. Keep abreast of current information and changes impacting Patient Accounting customer service and organize relevant information for daily reference.

16. Responsible for reading, understanding, and complying with all departmental and job-specific policies and procedures within the Department.

17. Responsible for follow up on account by performing necessary charge void and charge entry actions resulting from inquires or incorrect billings (i.e. coding, waiver, credits).

18. Re-issue claims and statements when necessary and resubmit to appropriate parties.

19. Act as HP wide resource for medical service fee estimates and document according to department procedures.

20. Responsible for knowing and understanding benefit structures provided and administered by HealthPartners, its subsidiaries, and insurance companies.

Identify and propose solutions to problems which contribute to customer dissatisfaction in order to reduce future complaints or errors.

22. Assist in orientation for new Patient Accounting staff. Operates as a member of Patient Accounting Team in support of other staff.

23. Completes assigned projects and duties in a timely manner.

24. Informing management/supervisor of deficiencies and erroneous items or codes in Resolute (billing system) master files.

25. Perform other duties as required to accomplish departmental goals and meet patient needs.

HealthPartners is nationally acclaimed for providing outstanding patient care and we offer an excellent salary and benefits package. HealthPartners is an Equal Opportunity Employer. To see a complete job description and/or to apply for this position, please visit, click on job opportunities and search for Job ID #24971.

Health is what we do. Partnership is how we do it.


Additional Information

This Patient Account Representative will be working in the Call Center department.

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