Patient Account Representative

Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.

The Patient Account Representative is part of a team of specialized staff that share an unsurpassed dedication to the community we serve, respecting individual contributions, we value excellence, integrity and continuous improvement. Our commitment to our patients and our values drives us to provide the financial resources essential to serve our community and SJRMC by identifying opportunities to attain reimbursement from third party payers.

Required Behaviors:

• As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization: Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.

Required Qualifications:

• High School Diploma or equivalent
• Computer experience
• Ability to speak, read and write in English
• Strong communication skills: verbal and listening, primarily in telephone conversation, and written
• Ability to work with minimal supervision
• Ability to interface ethically and professionally with all levels of management
• Demonstrates ability to deliver quality work within tight deadlines.
• Independent decision making and discretion.
• Ten (10) key/calculator by touch proficiency

Preferred Qualifications:

• One (1) year of experience in health care or insurance
• Knowledge of third party reimbursement methodologies, especially in hospital setting
• Knowledge of CPT/HCPCS coding
• Previous Meditech experience
• Medical Terminology

Duties and Responsibilities:

• Document summary of communication in the inter facility system(s)
• Maintain knowledge of changing insurance requirements through internal/external training and/or communication
• Communicate additional information/requests needed to the appropriate personnel for further action
• Use personal judgment and initiative to develop effective and constructive solutions per established Guide lines and policies
• Manage, organize and update relevant data using database applications
• Facilitate to expedite reimbursement
• Works in conjunction with other facility departments
• Transmits, works edits, rejections and follow up on pended claims. Works any and all necessary reports as needed
• Acts as a resource to Patient Accounts staff regarding third party payer requirements and contractual issues
• Analyze and interpret data from payers explanation of payments, to confirm proper reimbursement is made according to contract
• Maintain knowledge of daily cashiering functions
• Greeting customer, answering questions or providing directions always in such a way that positively affects the customers perception or experience
• Each employee is responsible for implementing SJRMC’s Service Standards into their daily work:

                                                     Safety, Courtesy, Effectiveness, and Stewardship

• Other duties as assigned

Physical Demands and Environmental Work Conditions:

Physical Activities:

• Extended sitting
• Extended talking
• Extended reading
• Extended listening
• Extensive repetitive motions of both hands, such as: wrist/hand movements, grasping, finger dexterity (as in typing, writing, faxing, filing, etc.)
• Ability to lift up to 50 pounds.

Work Environment:

• The typical noise level will vary from quiet to very loud
• Occasional mild variance in room temperature

Sensory Requirements:

• The employee will need adequate ability to see (both close and distant objects, adjust visual focus)
• The employee will need adequate ability to hear (human speech, primarily telephone communication, verbal instructions, etc.)