Patient Account Representative – Medicare/Medicaid Exp

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

📋 Description

• Execute collections, follow up on accounts, and post billing allowances for designated accounts.

• Contact payers through phone, email, fax, or websites to address unresolved claims.

• Review and accurately revise patient and financial details.

• Confirm responsible parties and insurance payment details.

• Oversee billings for accuracy and rectify any discrepancies.

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

• Timely bill hospital services to primary insurers or patients accurately.

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

• Detect and report trends in underpayments and denials.

• Analyze and resolve issues leading to delays in payer payments and initiate appeals when required.

• Manipulate Excel spreadsheets and communicate the results effectively.

• Achieve departmental productivity and quality benchmarks.

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

• Limit access to protected health information to what is deemed necessary.

• Execute other assigned responsibilities.

⛳️ Requirements

• High School Diploma or equivalent is mandatory.

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

• Experience in Hospital/Facility billing is necessary.

• 2-3 years of experience in insurance collections, including the submission and follow-up of claims.

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

• Capability to utilize workflow and client host systems such as STAR, SMS, EAGLE, and EPIC.

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

• Familiarity with government, Medicare, and Medicaid claims.

• Basic math and typing abilities.

• Proficient in Microsoft Office Suite.

• Excellent interpersonal, written, and verbal communication skills.

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

• High degree of integrity and dependability, along with a strong sense of urgency and results-driven attitude.

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

🏝️ Benefits

• Comprehensive health insurance package.

• Retirement savings plan with employer contributions.

• Opportunities for professional development and advancement.

• Flexible work hours and a supportive work environment.