Job Summary:

The Commercial Patient Account Representative, Lead, is responsible for assisting staff with the commercial billing and/or collection of accounts to ensure that PFS is capturing all revenues as timely and efficiently as possible. 

Duties & Responsibilities:

• This position will have working knowledge and understanding of managed care contracts including other complex payment methodologies to ensure prompt and accurate reimbursement.
• This position must be able to utilize and understand many complex and varying State and Federal statutes and regulations, guidelines and systems, and perform the account follow-up function with all Commercial payors and government agencies to obtain maximum and correct reimbursement of accounts receivables.  
• This position proactively interacts with insurance companies, government agencies and/or patients to obtain maximum and correct reimbursement of accounts receivable.  I
• This position works with all payors and internal resources to identify and resolve issues that hinder account payment. 
• Applies independent judgment, research and knowledge to audit payor payments, denials, appeals and billing issues.
• Assists with department workload and provides support to staff, as directed. 
•  Supports Management with day-to-day operations and works closely with the department Coordinator to ensure a high level of performance with a commitment to continuous improvement