Patient Account Representative

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Engage with payers to facilitate prompt resolution of pending claims through various communication methods including phone, email, fax, or websites.

• Accurately review and update patient and financial information.

• Confirm the individual or insurance entity accountable for payment.

• Oversee billing precision and rectify known discrepancies.

• Track Medicaid/Healthy Options coupons to guarantee services are billed within anticipated timeframes.

• Accurately bill hospital services to primary insurers or patients.

• Follow up with insurance companies regarding assigned accounts.

• Clarify hospital payment regulations and stay informed about insurance regulations and hospital contracts.

• Recognize and report trends in underpayments and denials.

• Investigate and resolve issues that lead to delays in payer payments and initiate appeals as required.

• Manipulate Excel spreadsheets and communicate findings effectively.

• Achieve daily productivity and quality benchmarks.

• Undertake special projects and additional responsibilities as needed.

• Maintain confidentiality and manage protected health information in compliance with HIPAA standards.

⛳️ Requirements

• High School Diploma or equivalent is mandatory.

• Certification in Medical Billing and Coding is preferred, though not essential.

• Experience in Hospital/Facility billing is required.

• 2–3 years of experience in insurance collections, including submitting and tracking claims.

• Basic understanding of healthcare claims processing, including ICD-9/10, CPT, HCPC codes, and UB-04.

• Proficient in using workflow and client host systems such as STAR, SMS, EAGLE, and EPIC.

• Familiarity with the insurance follow-up process and healthcare reimbursement methodologies.

• Knowledge of government, Medicare, and Medicaid claims.

• Proficiency in Microsoft Office, particularly Excel and Word.

• Capability to work independently as well as collaboratively in a team setting.

• Strong organizational, communication, and writing skills.

• Basic math and typing abilities.

• Aptitude to follow instructions, collaborate with others, and manage stress effectively.

• Capacity to perform the physical and office equipment-related tasks listed.

🏝️ Benefits

• Comprehensive health and wellness programs.

• Opportunities for professional development and advancement.

• Supportive and collaborative work environment.