Patient Account Representative – Hospital Experience

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

📋 Description

• Engage with payers via phone, email, fax, or websites to resolve unresolved claims.

• Examine and update patient and financial records.

• Confirm responsible parties and verify insurance details for payment.

• Oversee billing accuracy and rectify any discrepancies.

• Track Medicaid/Healthy Options coupons and billing timelines.

• Accurately and promptly bill hospital services to primary insurers or patients.

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

• Detect and report underpayments and denial patterns.

• Investigate and resolve reasons for payer payment delays and initiate appeals as necessary.

• Manipulate Excel spreadsheets and convey results effectively.

• Achieve departmental productivity and quality benchmarks.

• Uphold confidentiality and adhere to HIPAA and information security standards.

• Utilize, safeguard, and disclose PHI only as allowed by HIPAA.

• Carry out other assigned responsibilities.

⛳️ Requirements

• A High School Diploma or equivalent is required.

• Medical Billing and Coding certification is preferred but not mandatory.

• Experience in Hospital/Facility billing is essential.

• 2-3 years of experience in insurance collections, including submitting and following up on claims.

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

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

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

• Understanding of government, Medicare, and Medicaid claims.

• Basic math and typing capabilities.

• Proficient in Microsoft Office Suite.

• Excellent interpersonal, written, and verbal communication abilities.

• Strong problem-solving and innovative thinking skills.

• Capacity to exercise sound judgment and make informed decisions based on timely and accurate analyses.

• High degree of integrity and reliability, with a strong sense of urgency and results orientation.

• Must have a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes.

• Ability to follow instructions, collaborate with team members, and manage stress effectively.

🏝️ Benefits

• Competitive salary and benefits package.

• Opportunities for professional development and growth.

• Supportive work environment with a focus on teamwork.

• Health and wellness programs.