Patient Account Representative Remote

About the Role

The Patient Account Representative is responsible for collections, account follow-up, and billing allowance posting for assigned accounts.

Responsibilities

• Follow up with payers to ensure timely resolution of all outstanding claims via phone, email, fax, or websites.
• Review and update all patient and financial information accurately as provided.
• Verify that information correctly identifies the individual or insurance company responsible for payment.
• Monitor all billings for accuracy, updating any that contain known errors.
• Monitor Medicaid/Healthy Options coupons to ensure services are billed within expected timeframes.
• Bill all hospital services to the primary insurer or patient correctly and within the expected timeframe.
• Follow up with insurance companies on all assigned accounts within the expected timeframe.
• Explain hospital regulations regarding payment methods and maintain a working knowledge of insurance regulations and hospital insurance contracts.
• Identify and report underpayments and denial trends.
• Analyze, identify, and resolve issues causing payer payment delays; initiate appeals when necessary.
• Manipulate Excel spreadsheets and communicate results.
• Meet and maintain daily productivity and quality standards established in departmental policies.
• Act professionally, cooperatively, and courteously with patients, insurance payors, co-workers, management, and clients.
• Perform special projects and other duties as needed by the management team.
• Maintain confidentiality at all times.
• Use, protect, and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

Requirements

• High School Diploma or equivalent required.
• Medical Billing and Coding certification preferred but not required.
• Experience in Hospital/Facility billing required.
• 2-3 years’ experience in insurance collections, including submitting and following up on claims.
• Basic knowledge of healthcare claims processing, including ICD-9/10, CPT, HCPC codes, and UB-04.
• Ability to use workflow systems and client host systems such as STAR, SMS, EAGLE, and EPIC, as well as other tools to collect payments and resolve accounts.
• Working knowledge of the insurance follow-up process with an understanding of healthcare reimbursement methodologies.
• Understanding of government, Medicare, and Medicaid claims.
• Proficiency with Microsoft Office, including Excel and Word.
• Ability to work well individually and in a team environment.
• Strong organizational, communication, and written skills.
• Basic math and typing skills.

Working Conditions

Physical Demands

• Occasionally required to move around the work area.
• Sit, perform manual tasks, and operate tools and office equipment such as computers, peripherals, and telephones.
• Extend arms, kneel, talk, and hear.

Mental Demands

• Must be able to follow directions, collaborate with others, and handle stress.

Work Environment

The noise level in the work environment is usually minimal.