Patient Account Representative

Education: High School Diploma or GED Required
1 3 years in hospital accounts receivable, medical collections follow up, or healthcare collections.

REQUIRED: EXPERIENCE WITH INPATIENT AND OUTPATIENT COLLECTION




UB04 Facility experience
Collections for facility claims -all lines of business
Knowledge of hospital billing processes, CPT/ICD codes, and DRG reimbursement.
Familiarity with payer guidelines such as Medicare, Medi-cal and commercial payers
Strong communication skills for payer interactions.
Proficiency in hospital billing and follow up systems and Microsoft Office.
Attention to detail and ability to analyze claim denials and payment variances.




Review hospital accounts receivable aging reports and prioritize collection efforts.
Contact insurance carriers to collect outstanding balances and resolve issues.
Knowledge in follow up for institutional claims ( UB04)
Investigate and appeal denied or underpaid claims to maximize reimbursement.
Coordinate with other departments such as billing team to resolve discrepancies.
Document all collection activities in the hospital's system
Ensure compliance with HIPAA, hospital policies, and state/federal regulations.
Obtaining Eligibility via website/insurance portals, insurance customer service