Patient Account Representative – Hospital Medicare Experience

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

📋 Description

• Conduct collections, account follow-ups, and billing allowance postings for designated accounts.

• Communicate with payers via phone, email, fax, or websites to resolve pending claims.

• Review and accurately update patient and financial information.

• Verify the responsible individual or insurance company for bill payments.

• Monitor billing for accuracy and rectify any errors.

• Track Medicaid/Healthy Options coupons to ensure services are billed within the expected timeframes.

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

• Explain hospital payment regulations while staying informed about insurance regulations and contracts.

• Identify and report trends in underpayments and denials.

• Analyze and address issues causing delays in payer payments, initiating appeals when necessary.

• Manipulate Excel spreadsheets and communicate results effectively.

• Meet daily productivity and quality benchmarks.

• Engage professionally with patients, insurance payors, colleagues, management, and clients.

• Maintain confidentiality and handle, use, and disclose PHI in compliance with HIPAA.

• Adhere to Information Security and HIPAA policies and procedures.

• Limit PHI access to the minimum necessary level.

• Perform additional duties as assigned.

⛳️ Requirements

• High School Diploma or equivalent is required.

• Certification in Medical Billing and Coding is preferred but not mandatory.

• Experience in Hospital/Facility billing is required.

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

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

• Ability to utilize 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 skills are required.

• Proficiency with the Microsoft Office Suite.

• Strong interpersonal and communication skills.

• Excellent problem-solving and creative skills, along with sound judgment and decision-making abilities.

• High level of integrity and dependability, demonstrating urgency and results orientation.

• Exceptional written and verbal communication skills are required.

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

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

🏝️ Benefits

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

• Work in an environment that typically has minimal noise.