Patient Accounts Representative, Customer Service Rep

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

📋 Description

• Act as the main point of contact for patients by addressing inquiries related to billing, insurance processing, account status, payment plans, and financial concerns in a professional and compassionate manner.

• Provide guidance to patients regarding their insurance coverage, Explanation of Benefits (EOBs), payer processing timelines, denials, adjustments, payment expectations, financial options, and available payment arrangements.

• Investigate and resolve patient account inquiries by analyzing charges, payments, insurance activities, denials, eligibility, and account balances, utilizing payer portals, online resources, and direct communication with patients and third-party payors to facilitate timely account resolution.

• Update and maintain precise patient demographic, insurance, eligibility, and plan information within electronic health record (EHR) and revenue cycle systems to ensure accurate registration, billing, clean claim processing, and resolution of payor-related issues and trends.

• Assess insurance eligibility, payer requirements, benefits, and financial clearance prerequisites to support timely and precise financial management activities in accordance with organizational policies and standard operating procedures.

• Generate accurate cost-of-care estimates and convey expected patient financial responsibilities, including deductibles, co-payments, coinsurance, self-pay balances, and other out-of-pocket expenses.

• Work collaboratively with insurance, billing, coding, financial clearance, medical records, and operational teams to ensure timely account resolution, accurate reimbursement, effective communication of financial clearance decisions, identification of billing or coding discrepancies, and clean claim processing.

• Conduct outbound follow-ups with patients and third-party payors concerning outstanding balances, missing information, payment arrangements, collection efforts, and unresolved account matters while appropriately escalating payment delays and aging trend concerns.

• Calculate, collect, and process patient self-pay liabilities and outstanding balances utilizing approved secure payment methods and establish payment arrangements in line with organizational guidelines.

• Thoroughly and accurately document all patient interactions, account research, financial discussions, dispute activities, actions taken, findings, and resolutions within designated systems to support account follow-up, audit readiness, and operational communication.

• Effectively manage high-volume workflows, competing priorities, and interruptions while upholding quality, accuracy, and productivity standards.

• Ensure adherence to HIPAA, State and Federal regulations, payer guidelines, organizational policies, quality standards, productivity expectations, and established standard work processes.

⛳️ Requirements

• High School Diploma or GED is required.

• A minimum of 2 years of practical knowledge in medical office or customer service.

• Call Center experience is preferred.

• Familiarity with Epic EHR is preferred.

• Strong computer/10 key skills with the capacity to type at least 40 words per minute.

• Proficient in Microsoft Office Suite, with comfort in using Excel and Word.

• Outstanding interpersonal communication and customer service skills.

🏝️ Benefits

• Healthcare Options: PPO, HDHP, and Surest plans with a $100/month discount for tobacco-free individuals.

• Dental & Vision Insurance.

• 401(k) with Annual Employer Contributions.

• Additional Coverage: HSA/FSA, short- and long-term disability, life and AD&D, legal assistance, and more.

• Employee Assistance Program (EAP): Employer-paid support for life’s challenges.

• Generous Paid Time Off: Up to 4 weeks of PTO upon starting, increasing with tenure, plus 7 paid holidays and 2 floating holidays.