Patient Account Representative

Patient Account Representative

Occupational Summary

The Patient Account Representative performs administrative duties related to medical insurance claims processing and patient accounts. Specific knowledge of medical terminology as well as inpatient and outpatient surgery, hospital, or clinic procedures. Duties include patient phone calls and correspondence, medical insurance and third-party payer phone calls and correspondence.

Work Performed

Review and verify patient accounts and patient information. Prepare patient statements for charges not covered by insurance on a monthly schedule. Perform collections for patient past due accounts, contacting patients via phone calls and letters. Works with patients to establish payment plan for past due accounts. Provides necessary information to an outside collection company for delinquent accounts.

Answer patient questions on copays, coinsurance, deductibles, etc. Verify patient benefits eligibility and coverage. Resolves patient grievances in a calm and professional manner.

Review and verify medical insurance denials and reprocess insurance claims, as necessary. Follow up with insurance company on unpaid claims and re-submits claims. Prepares appeal letters to insurance carrier when necessary for claims denials.

Maintain an understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques to effectively apply ICD-10 and CPT coding guidelines to inpatient and outpatient diagnoses and procedures.

Communicate with facilities and staff for needed documentation for accurate coding. Assist with special projects as required, and perform other related duties incidental to the work. Must maintain the strictest adherence to compliance and patient confidentiality.

Required Skill Set

Professional and dependable

Excellent phone skills

Ability to work independently

Attention to detail, accurate, and organized

Knowledge of medical terminology and coding

Familiarity with insurance explanations of benefits and denial codes

Excellent interpersonal, verbal, and written skills

EMR software, Microsoft Word and Excel

HIPAA compliance

Minimum Education/Experience

High school diploma required, and 2 years of experience in a medical office or medical billing setting required. Associates degree or Medical Office Certificate preferred.

About Our Company

We are a revenue cycle management company in the Raleigh-Durham area. We employ credentialed medical coders and billing analysts to handle all aspects of the revenue cycle for our clients. We offer a competitive salary, paid medical and dental insurance, retirement benefits, life and disability insurance, as well as a generous PTO policy for our valued employees.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Education:

• High school or equivalent (Preferred)

Experience:

• Medical Office/Billing: 1 year (Preferred)

Work Location: Hybrid remote in Morrisville, NC 27560