Patient Collections Representative

Job Description

Job Description

The Patient Collections Representative is responsible for recovering outstanding patient balances. This role focuses on patient outreach, balance resolution, and prevention of revenue leakage while maintaining compliance with healthcare regulations and delivering a professional patient experience.

Key Responsibilities

PTP Collections Management

• Identify accounts where payment was issued to the patient instead of the lab.
• Review EOBs, remits, and payer correspondence to validate balances owed.
• Initiate outbound calls, letters, and electronic communication to patients regarding repayment.

Patient Outreach & Communication

• Explain insurance payments, patient responsibility, and repayment expectations clearly.
• Handle sensitive financial discussions with professionalism and empathy.
• Negotiate payment arrangements when appropriate.

Account Resolution

• Secure payments via phone, mail, or online payment platforms.
• Set up and monitor payment plans.
• Escalate delinquent accounts according to internal collection workflows.

Collections Workflow

• Generate and send PTP demand letters and follow-up notices.
• Document all collection activities in the billing system.

Insurance & Billing Research

• Work denied/misdirected claims tied to PTP balances.
• Coordinate with payers to request reissues or recoupments when applicable.
• Collaborate with internal billing and AR teams to resolve discrepancies.

Compliance & Reporting

• Ensure adherence to HIPAA, FDCPA, and state collection regulations.
• Maintain accurate account notes and audit trails.
• Track recovery metrics, aging, and collection performance.

Required Qualifications

• Associate’s or Bachelor’s preferred
• 2+ years of medical billing or healthcare collections experience.
• Paid-to-Patient or patient balance collections experience strongly preferred.
• Knowledge of EOBs, remittance advice, and insurance payment processes.
• Diagnostic lab billing experience (toxicology/clinical) preferred.

Skills & Competencies

• Strong negotiation and conflict-resolution skills.
• Professional, firm, and respectful communication style.
• Ability to explain complex insurance concepts to patients.
• Detail-oriented with strong account research abilities.
• Comfortable handling high-volume outbound call activity.
• Proficient in billing systems, clearinghouses, and Microsoft Office. (Advanced MD is a plus)

Compensation

Hourly Pay Range: $26.00 – $30.00 per hour

Pay is based on experience, diagnostic lab specialty knowledge, and recovery performance.

Bonus / Incentive.

• Tiered commission after baseline recovery threshold.