The Patient Account Representative is responsible for collections, account follow-up, and billing allowance posting for assigned accounts.
- Follow up with payers to ensure timely resolution of outstanding claims via phone, email, fax, or web portals
- Review and update patient and financial information accurately
- Verify responsible party information for bill payment
- Monitor billings for accuracy and correct known errors
- Ensure Medicaid/healthy options coupons are billed within expected timeframes
- Bill hospital services to the primary insurer or patient correctly and on time
- Follow up with insurance companies on assigned accounts
- Explain hospital payment regulations and maintain working knowledge of insurance regulations and contracts
- Identify and report underpayments and denial trends
- Analyze and resolve issues causing payer payment delays and initiate appeals when needed
- Use Excel spreadsheets to track and communicate results
- Meet daily productivity and quality standards
- Maintain confidentiality and comply with HIPAA and information security policies
- Perform special projects and other duties as assigned
Requirements & Qualifications
- High school diploma or equivalent required
- Medical billing and coding certification preferred, but not required
- Experience in hospital/facility and/or physician billing required
- 2-3 years of experience in insurance collections, including submitting and following up on claims
- Basic knowledge of healthcare claims processing, including ICD-9/10, CPT, HCPCS, and UB-04
- Ability to use workflow systems and client host systems such as STAR, SMS, EAGLE, and EPIC
- Working knowledge of insurance follow-up processes and healthcare reimbursement methodologies
- Understanding of government, Medicare, and Medicaid claims
- Proficiency with Microsoft Office Suite, including Excel and Word
- Strong math, typing, communication, and interpersonal skills
- Strong problem-solving ability and sound judgment
- High integrity, dependability, urgency, and results-oriented mindset
Location
New Jersey, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
2 months ago