Patient Account Representative II

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

📋 Description

• Accurately and promptly process patient claims for insurance balance in accordance with contracts and policies.

• Address unpaid, underpaid, denied, or unresolved patient accounts.

• Respond to requests from payers by supplying medical records or necessary documentation via mail or payer portals.

• Follow up on outstanding patient accounts in Epic through phone or payer portal communication.

• Resolve claim edits effectively.

• Examine payer variances and pursue any underpayments.

• Review and address payer rejections and denials, and conduct basic appeals as necessary.

• Edit and submit both electronic and hardcopy claims to payers.

• Identify potential trends and escalate them as needed.

• Post payments and related adjustments within Epic.

• Manage and resolve credit balances accordingly.

• Execute basic charge corrections efficiently.

⛳️ Requirements

• Possess a high school diploma or GED equivalent.

• Have two (2) years of progressively responsible and directly related work experience.

• Achieve weekly individual productivity goals and standards while adhering to planned priorities.

• Maintain professional communication with PFS staff, payers, and patients.

• Follow both oral and written instructions, accurately interpreting policies.

• Communicate clearly and professionally in both verbal and written formats.

• Ensure confidentiality of sensitive information is upheld.

• Perform basic mathematical calculations.

• Plan, prioritize, and meet established deadlines.

• Collaborate effectively with individuals across all levels of the organization.

• Familiarity with accounts receivable software systems and medical billing operations is required.

• Understanding of medical reimbursement policies, procedures, and terminology is essential.

• Knowledge of the payer landscape, including Medicare, Medicaid, Workers’ Compensation, Managed Care, and commercial insurance.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and career advancement.

• Supportive work environment that values teamwork and collaboration.