Patient Accounts Representative

Description

POSITION SUMMARY

The Patient Accounts Representative is responsible for the administration, coordination, and follow-up of self-pay and patient account functions within the agency’s Revenue Cycle Department. This role serves as the primary internal resource for client account inquiries, payment arrangements, self-pay billing processes, and related account maintenance activities.

The Patient Accounts Representative supports the financial integrity of the organization while promoting a respectful, client-centered approach consistent with the mission and values of a Community Mental Health Center (CMHC). Responsibilities include management of patient statements, payment collection processes, financial assistance coordination, account follow-up, and collaboration with internal departments to resolve billing concerns. The role ensures compliance with CMHC He-M standards, Medicaid and Medicare regulations, HIPAA requirements, and agency fiscal policies.

ESSENTIAL RESPONSIBILITIES

Patient Account Administration

• Generate and process patient statements for self-pay balances in accordance with agency billing cycles and procedures.
• Review and maintain patient account balances for accuracy, including verification of payments, adjustments, and outstanding balances.
• Establish and monitor payment arrangements consistent with agency policy.
• Communicate with clients regarding outstanding balances, payment options, and financial responsibilities in a professional and respectful manner.
• Assist clients with understanding insurance coverage, patient responsibility amounts, and available financial assistance resources.
• Process client payments received via mail, phone, electronic payment systems, or in person in accordance with internal control procedures.

Account Follow-Up & Collections Support

• Perform timely follow-up on outstanding self-pay balances and delinquent accounts within assigned scope.
• Monitor aging reports and prioritize account follow-up activities to support agency collection goals.
• Coordinate payment reminders, collection correspondence, and account resolution efforts in accordance with agency policies and applicable regulations.
• Escalate unresolved balances, disputed accounts, or complex financial concerns to the Accounts Receivable Supervisor as appropriate.
• Assist with preparation of accounts for external collection processes when authorized.

Client Service & Financial Communication

• Serve as a point of contact for client billing and account-related inquiries.
• Provide clear, compassionate, and professional communication regarding balances, payment expectations, and available support options.
• Maintain professional interactions with clients who may be experiencing financial hardship, behavioral health concerns, or emotional distress.
• Collaborate with clinical and administrative staff to resolve account discrepancies and support continuity of care.

Payment Posting & Account Maintenance

• Post patient payments accurately and timely within the electronic medical record and billing systems.
• Process account adjustments, balance transfers, refunds, and payment corrections in accordance with agency procedures and supervisory approval requirements.
• Maintain accurate demographic, insurance, guarantor, and billing information within the electronic record system.
• Assist with reconciliation activities and documentation retention to support audit readiness and financial accuracy.

Compliance & Documentation

• Maintain accurate, timely, and organized documentation of account activities and communications.
• Safeguard protected health information (PHI) in compliance with HIPAA, He-M standards, and agency confidentiality requirements.
• Adhere to agency fiscal policies, internal controls, and regulatory requirements related to billing and collections activities.
• Participate in departmental workflow improvement initiatives and ongoing training activities.
• Perform additional duties related to patient account operations as assigned by the Accounts Receivable Supervisor.

Requirements

MINIMUM QUALIFICATIONS

High School diploma or equivalent required.

Minimum of two (2) years of experience in medical billing, patient accounts, customer service, healthcare administration, or related field.

Proficiency with computerized billing systems, Microsoft Office applications, and standard office technology.

Strong organizational, communication, and customer service skills.

Preferred Qualifications

Experience in a Community Mental Health Center (CMHC) or behavioral healthcare setting.

Experience working with self-pay billing, patient statements, payment plans, or collections support.

Familiarity with Medicaid, Medicare, managed care, and healthcare revenue cycle processes.

Experience with electronic medical record and practice management systems.

OTHER EXPECTATIONS

Maintain professional conduct consistent with agency values and CMHC standards.

Maintain strict confidentiality regarding client, financial, and personnel matters.

Adhere to attendance, leave, and notification policies to ensure departmental coverage.

Participate in ongoing professional development and annual learning plans.

Seek supervisory guidance when issues exceed role authority or involve regulatory interpretation.

Demonstrate flexibility and willingness to support departmental operations as needed.

OSHA RATING

This position is classified as Low Risk due to primarily office-based duties with minimal exposure to clinical environments. The employee is expected to comply with all OSHA regulations and agency safety policies.