About the role
We are seeking a highly organized and detail-oriented Billing Specialist / Patient Account Representative to support accurate and efficient revenue cycle operations. This role plays a critical part in managing patient accounts by ensuring timely resolution of outstanding patient balances, supporting account reconciliation, coordinating insurance and patient payment activity, and assisting with legacy account cleanup during system transitions. The ideal candidate is customer-service driven, detail-oriented, and experienced in patient financial services, payment arrangements, insurance coordination, and account resolution while maintaining a strong commitment to accuracy, compliance, and continuous process improvement.
Our values
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What you'll do
- Review and resolve outstanding patient and insurance accounts by researching discrepancies, resolving claim issues and denials, contacting patients regarding outstanding balances, answering billing questions, and establishing payment arrangements to facilitate timely account resolution.
- Maintain a strong understanding of payer policies, VBC metrics, RAF/HCC coding relevance, and risk adjustment impacts on reimbursement.
- Review and resolve outstanding accounts receivable (AR) and insurance denials by analyzing claims, researching discrepancies, and submitting appeals as needed.
- Prepare, review, and submit clean medical claims for primary and secondary payers, including Medicare Advantage, Medicaid Managed Care, and commercial insurers as needed.
- Collaborate with internal departments and payers to identify root causes of denials and ensure timely resolution and reimbursement.
- Maintain patient confidentiality and demonstrate professionalism and empathy when discussing sensitive financial matters.
- Support audits, data clean-up initiatives, and quality reporting related to billing.
- Ensure compliance with HIPAA and all regulatory requirements.
Qualifications
- High school diploma or equivalent required; associate degree or billing certification (e.g., CPB, CMRS, CBCS) preferred.
- At least 2 years of medical billing experience in a multi-specialty or primary care setting preferred.
- Experience with Medicare Advantage, HMO, PPO, and/or value-based payment models strongly preferred.
- Familiarity with EMR and billing software (e.g., eClinicalWorks, Athena, NextGen, Kareo).
- Working knowledge of CPT, ICD-10, HCPCS, and modifier usage.
- Strong attention to detail, organizational skills, and follow-through.
- Excellent communication and teamwork skills.
Working conditions
- Schedule options: 7:30 AM–4:00 PM or 8:00 AM–4:30 PM with a 30-minute lunch between 12:00–1:00 PM.
Location
Las Vegas, Nevada, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago