Patient Account Specialist

Role Overview

The Patient Account Specialist role at Hopebridge is designed for someone who can independently manage complex account scenarios, interpret nuanced payer activity, and serve as a knowledgeable resource for both families and internal partners.

Responsibilities

• Lead resolution of complex patient account issues involving denials, COB discrepancies, payer processing variances, high balances, and unresolved reimbursement activity.
• Perform advanced account analysis to identify root causes, evaluate payer behavior, and determine the most effective path to resolution.
• Interpret EOBs, benefit structures, authorization or coverage limitations, and payer communications to explain financial outcomes clearly to families and internal stakeholders.
• Manage escalated family financial conversations related to balances, claims outcomes, payment expectations, hardship support, and account next steps.
• Collaborate cross-functionally with internal departments to address account barriers, improve handoffs, and support accurate downstream account handling.
• Support payer follow-up, insurance reverification, account correction workflows, and documentation practices that strengthen account accuracy and timely resolution.
• Serve as an experienced resource to team members by sharing knowledge, reinforcing best practices, and contributing to consistent revenue cycle processes.

Required Skills

• 3+ years of experience in healthcare revenue cycle, patient financial services, denial resolution, medical billing, or complex patient account management.
• Advanced knowledge of benefit verification, EOB interpretation, COB, payer policies, reimbursement workflows, and claim lifecycle concepts.
• Demonstrated ability to research, prioritize, and resolve complex account issues with a high level of accuracy and independence.
• Strong communication and relationship-management skills, including the ability to explain technical billing and insurance concepts in a clear, professional manner.
• Experience collaborating across teams and serving as a subject matter resource within revenue cycle or patient financial operations.
• Proficiency with EHRs, payer portals, account documentation workflows, and productivity expectations in fast-paced healthcare environments.
• Experience in pediatric, behavioral health, or ABA billing is strongly preferred.