University of Washington Human Resources

UNIVERSITY OF WASHINGTON

Specification for Class

PATIENT ACCOUNT REPRESENTATIVE 2

UW CODE AND REPRESENTATIVE GROUP

18172 (NE S SEIU 925 Non Supv)
21224 (NE H SEIU 925 Non Supv)

CLASS SERIES CONCEPT

Process and resolve patient accounts receivable.

BASIC FUNCTION

Process the full scope of activities related to the patient accounts receivable. Patient accounting functions include billing, follow-up, collections, incoming inquiries, audit resolutions, cash applications, credit balance resolutions, and registration updates.

DISTINGUISHING CHARACTERISTICS

Under general supervision, apply judgement and analytical skills to determine and take appropriate course of action for resolution of patient accounts. Positions in this classification have extensive communication with patients, clinical support staff, and/or third-party payers.

TYPICAL WORK

Using resource materials such as payer/provider instruction manuals, provider bulletins, hospital policies and procedures, audit information on third-party claim forms for accuracy and completeness, to ensure submission of clean claims

Analyze unresolved accounts and/or unpaid claims and determine appropriate follow-up activity based on departmental guidelines and payer requirements;

Determine and post adjustments to patient accounts according to departmental procedures;

Use available payer resources to verify eligibility and/or expedite resolution of rejections and denials;

Communicate with patients, payers, agencies, and other departments to resolve patient account balances;

Perform billing, guarantor account, coverage and demographic updates to assist in securing payment for services in an accurate and timely manner;

Analyze reimbursement for accuracy;

Evaluate financial information provided by patients to determine eligibility for UW Medicine’s Financial Assistance policy, determine their ability to make payment; advise patients on appropriate payment plans;

Review delinquent accounts for referral to collection agencies when collections efforts have been unsuccessful;

Resolve credit balances through adjustments, or refunds to patients or payers;

Document activities accurately in all applicable systems, and in accordance with departmental policies and procedures;

Identify systemic payer or provider issues and either resolve or escalate to management for resolution;

Maintain confidentiality of information, including protected health information (PHI);

Participate in and attend meetings and training as required;

May take payments over the phone;

May assist in orienting and training new staff;

Perform the duties of a Patient Account Representative 1; and

Perform related duties as required.

MINIMUM QUALIFICATIONS