Patient Accounts Representative

Role Overview

The Patient Accounts Representative plays a key role in the administration of patient accounts at a community health center. This position supports charge review and reconciliation, payment posting, denial management, overpayment resolution, claims processing, insurance billing, and the timely resolution of accounts assigned through Epic Revenue Cycle workqueues.

Responsibilities

• Process and reconcile 835 files, reimbursement payments, EOBs, cash receipts, and other payer transactions.
• Post payments accurately, reconcile claims, resolve rejections, and rebill when necessary.
• Monitor insurance accounts receivable, investigate outstanding claims, and follow up on denials through appeals, rebilling, and other resolution activities.
• Work claims, charge review, denial, and overpayment accounts in Epic Revenue Cycle workqueues.
• Review and resolve claim edits, billing exceptions, reimbursement discrepancies, and denial accounts.
• Process overpayment, refund, recoupment, and payer adjustment accounts according to organizational and payer guidelines.
• Review encounter forms, validate and post charges, and ensure claims contain correct service codes, fees, insurance billing information, and supporting documentation.
• Collaborate with providers to correct incomplete or incorrect service and diagnosis codes.
• Prepare and process patient bills and third-party claims.
• Communicate with patients and staff regarding billing discrepancies, payment posting, claims processing, denials, reimbursements, and overpayments.
• Support regulatory and funding requirements and assist with other departmental duties as needed.