Patient Account Representative II

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

📋 Description

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

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

• Conduct accounts receivable collections and follow up with payers.

• Examine payer clerical and technical denials and handle requests, including basic appeals.

• Enter payments in Epic and finalize batch reconciliation along with related adjustments.

• Review and rectify credit balances.

• Manage retroactive eligibility and registration processes.

• Reconcile underpayments effectively.

• Respond to payer inquiries by supplying medical records or other documentation through mail or payer portals.

• Follow up on unresolved patient accounts in Epic by contacting payers via phone or portal.

• Resolve claim edits, payer discrepancies, rejections, and denials; perform appeals when necessary.

• Edit and submit electronic or hardcopy claims to payers.

• Identify potential trends and escalate them appropriately.

• Execute basic charge corrections.

• Primarily work in Epic with general supervision, independently resolving standard queries and moderately complex tasks.

⛳️ Requirements

• High school diploma or GED equivalent required.

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

• Must meet weekly individual productivity goals and standards while adhering to priorities set by the Team Manager.

• Ability to maintain professional communication with various PFS staff, payers, and patients concerning service billing.

• Capable of following both oral and written instructions and accurately interpreting institutional and other policies.

• Clear and professional communication skills, both verbal and written.

• Ability to maintain confidentiality of sensitive information.

• Proficient in basic mathematics.

• Skilled in planning, prioritizing, and meeting deadlines.

• Effectively work with individuals at all levels within the organization.

• Knowledgeable in accounts receivable software systems and medical billing operations.

• Familiar with medical reimbursement policies, procedures, and medical terminology.

• Understanding of the payer landscape, including Medicare, Medicaid, Workers’ Compensation, Managed Care, or other Commercial insurance.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement savings plan with company match.

• Generous paid time off and holiday schedule.

• Opportunities for professional development and advancement.

• Supportive work environment focused on teamwork and collaboration.