Patient Relations Representative V

Purpose of Position: The Patient Relations Representative performs coding quality audits of outpatient records to assure appropriateness and accurate code assignments in accordance with the NC Division of Health and Human Services Guidance and North Carolina Medicaid, and guidance of Commercial Insurance Providers. Employee must be knowledgeable of both charges and eligibility criteria for all the health department programs and clinics. Work also includes regular monitoring of all fee assessments, fee collections and payment plans done in the Health Department.

Knowledge, Skills, & Abilities: Substantive knowledge of office or work unit procedures, methods and practices. Substantive knowledge of and ability to use correct grammar, vocabulary, spelling, proofreading and office terminology to compose and/or proofread correspondence, reports and materials. Substantive knowledge of accounting procedures, applicable mathematics and their application in the work environment. Skill in communicating effectively both orally and in writing. Considerable ability to record, compile, summarize and analyze data. Considerable ability to review and process information to determine conclusions, actions or compliance with applicable laws, rules or regulations. Considerable ability to analyze work situations and interpret program content in making decisions and explaining policies, regulations and programs. Considerable ability to exercise judgment, discretion and negotiation skills in problem situations. Ability to learn, interpret and explain policies, regulations and programs. Ability to independently respond to inquiries and coordinate a variety of resources in acquiring and disseminating information. May require ability to train and manage a group of employees.