Patient Account Representative, Medicare/Medicaid

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

📋 Description

• Carry out collections, follow-up on accounts, and post billing allowances for designated accounts.

• Contact payers via telephone, email, fax, or websites to address outstanding claims.

• Review and accurately update both patient and financial information.

• Confirm the individual or insurance company accountable for payment.

• Oversee billings for accuracy and rectify any errors.

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

• Bill hospital services promptly and accurately to primary insurers or patients.

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

• Identify and report trends in underpayments and denials.

• Analyze and resolve issues leading to payer payment delays; initiate appeals when necessary.

• Manipulate Excel spreadsheets and communicate findings effectively.

• Achieve departmental daily productivity and quality benchmarks.

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

• Uphold confidentiality and manage protected health information in accordance with HIPAA and information security policies.

• Limit access to PHI to the minimum necessary level.

• Carry out additional duties as assigned.

⛳️ Requirements

• High School Diploma or equivalent is required.

• Medical Billing and Coding certification is preferred, though not mandatory.

• Experience in Hospital/Facility billing is essential.

• 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.

• Working knowledge of the insurance follow-up process and healthcare reimbursement methods.

• Familiarity with government, Medicare, and Medicaid claims.

• Basic math and typing abilities.

• Proficiency in Microsoft Office Suite.

• Excellent interpersonal and communication abilities.

• Strong problem-solving and creative skills; capacity to exercise sound judgment and make decisions based on accurate and timely analyses.

• High level of integrity and reliability with a pronounced sense of urgency and results orientation.

• Outstanding written and verbal communication skills are essential.

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

• Ability to perform specified physical tasks and operate office equipment.

• Capability to follow directions, collaborate with others, and manage stress effectively.

🏝️ Benefits

• Smartphone or electronic device capable of downloading applications provided/required for multifactor authentication and security purposes.

• Equal employment opportunity and non-discrimination protections.