Patient Account Representative

Job Details

Under the direction of the Hospital RRC Supervisor/Manager, the Hospital Patient Financial Services (PFS) Representative is responsible for reviewing and managing assigned third-party and patient accounts, ensuring timely billing and payment, and communicating complex issues to leadership.

• Reviews accounts assigned by work-queues or reports to determine appropriate actions.
• Performs actions such as initiating calls, submitting inquiries, writing appeals, recommending write-offs and adjustments, ensuring account balances are valued according to payers' contracts.
• Maintains productivity and quality standards as set by department policies.
• Participates in projects and audits as directed by leadership.
• Maintains compliance with regulatory and contract updates impacting reimbursement.
• Escalates and reports delays in claims adjudication.
• Assesses and corrects payments and transactions.
• Promotes positive patient experience and satisfaction.

Responsibilities

• Reviews accounts for appropriate actions.
• Performs actions such as initiating calls, submitting inquiries, writing appeals, recommending write-offs and adjustments.
• Maintains productivity and quality standards.
• Participates in root cause analyses and trend tracking.
• Collaborates with internal and external departments for issue resolution.
• Maintains compliance with regulatory and contract updates.
• Escalates and reports delays in claims adjudication.
• Assesses and corrects payments and transactions.
• Promotes positive patient experience and satisfaction.

Qualifications

• High School diploma or equivalent required.
• Licensure/Certification: Industry certification (AHIMA, HFMA, AAPC, etc.) preferred.
• Competent in patient accounting systems and associated applications.
• Knowledgeable in medical terminology, CPT, HCPCS, and ICD10 coding.
• Independent work ability with good judgment and multi-tasking skills.
• Detail-oriented with strong analytical problem-solving skills.
• Excellent customer service skills.
• Microsoft Office proficiency.
• Ability to maintain professional conduct and good working relationships.

Experience

• A minimum of two years' experience in healthcare billing, healthcare customer service, or a related field required.
• EHR experience (Epic preferred).

Education

• High School diploma or equivalent required.

Salary Range

USD $24.00 - USD $30.00 /Hr. This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate’s qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.