Patient Account Representative II (Remote)

1.0 FTE Full time, 08-hour day shift (United States of America)

About the role

The Patient Account Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. The PAR works in various capacities to support the primary goal of the business office to resolve unpaid, underpaid, denied, or unresolved patient accounts.

Responsibilities

• Respond to requests from payers, such as providing medical records or other documentation either by mail or via payer portals
• Follow up on unresolved patient accounts in Epic by contacting the payer by phone or via the portal
• Resolve claim edits
• Review payer variances and pursue underpayments to payers
• Review and resolve payer rejections, denials, and perform appeals as necessary
• Edit and submit electronic or hardcopy claims to payers
• Recognize potential trends and escalate them as appropriate
• Post payments in Epic, as well as related adjustments
• Resolve credit balances
• Complete basic charge corrections

Qualifications

Education: High school diploma or GED equivalent

Experience: Two (2) years of progressively responsible and directly related work experience

Skills

• Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager
• Maintains professional communication with various PFS staff, payers, and patients regarding the billing of services
• Ability to follow oral and written instructions and interpret institutional and other policies accurately
• Ability to communicate clearly and professionally both verbally and in writing
• Ability to maintain confidentiality of sensitive information
• Ability to perform basic mathematics
• Ability to plan, prioritize, and meet deadlines
• Ability to work effectively with individuals at all levels of the organization
• Knowledge of accounts receivable software systems and medical billing operations
• Familiarity with medical reimbursement policies and procedures and medical terminology
• Knowledge of payer landscape, including Medicare, Medicaid, Workers’ Compensation, Managed Care, or other Commercial insurance

Pay

Base pay scale: Generally starting at $33.89 - $38.15 per hour. The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty, and training.