Patient Account Representative I

The Patient Account Representative I supports healthcare revenue cycle functions including billing, insurance follow-up, patient account maintenance, collections, cash posting, and claim resolution. Team members work with patient accounts, insurance companies, billing systems, and internal departments to ensure claims are billed accurately and payments are collected within payer filing requirements.

Depending on assignment, this role may focus on billing, follow-up, collections, cash posting, or customer service functions. Responsibilities include responding to patient inquiries, contacting insurance companies regarding claims, resolving billing issues, maintaining patient accounts, and assisting with denial trend identification.

This role offers strong healthcare revenue cycle experience and exposure to multiple areas of patient financial services.

### Key Responsibilities

#### Billing Responsibilities

* Bill hospital and physician claims for inpatient and outpatient services
* Ensure claims are submitted within insurance filing deadlines
* Interpret payer requirements and billing guidelines
* Maintain patient accounts within billing and claims editing systems
* Respond to patient and commercial account inquiries
* Contact insurance companies regarding unreleased or unprocessed claims
* Work with vendors, insurance companies, and internal departments to resolve claim edits
* Notify analysts regarding billing edits and denial trends
* Support billing activities related to specialized package pricing programs

#### Follow-Up Responsibilities

* Follow up with insurance companies regarding outstanding claims
* Work patient accounts to obtain payment or account resolution
* Maintain patient accounts within hospital systems
* Respond to account inquiries by phone and written correspondence
* Review monthly Age Trial Balance reports
* Resolve third-party payer and self-pay claim issues
* Collaborate with vendors and insurance companies to resolve payment concerns
* Identify denial trends and system improvement opportunities

### Requirements

* High School Diploma or GED required
* One year of hospital financial services or patient services experience preferred
* Working knowledge of CPT, HCPCS, and ICD coding preferred
* Strong communication and customer service skills
* Ability to prioritize workload and manage deadlines
* Strong attention to detail and accuracy
* Ability to maintain patient confidentiality
* Ability to work effectively with insurance companies and healthcare departments

### Preferred Qualifications

* Associate Degree in Healthcare, Finance, or related field
* Equivalent combination of education and relevant experience may be considered
* Revenue cycle, billing, follow-up, collections, or patient financial services experience

### Benefits

Benefits not listed in the posting.

### Good Fit For

This role may be a strong fit for candidates with experience in medical billing, insurance follow-up, patient accounts, accounts receivable, revenue cycle, payment posting, healthcare collections, claim resolution, denial management, hospital billing, insurance verification, or patient financial services.