Patient Account Representative III Pro Fee (Onsite, Hybrid, Remote)

Job Description

At NorthBay Health, the Patient Account Representative III Ambulatory is responsible for the timely and accurate billing, follow-up and collection of ambulatory patient accounts. Each account representative is responsible for the processing of accounts for all services and specialties offered within the NorthBay Ambulatory practices through the use of standard and NorthBay prescribed billing practices and regulatory requirements.


PRIMARY JOB DUTIES

• Follow up responsibility on accounts with practices, carriers and/or patients account becomes zero balances through a combination of payment and adjustments per NorthBay guidelines and contracts.
• Managing account population to ensure AR aging is meeting or exceeding set goals.
• Timely processing for billing all initial claims including those edited through the billing scrubber.
• Timely processing of carrier denials to ensure maximum cash benefit.
• Other duties as assigned which include assisting with back logs as they arise.
• Other duties as assigned which may include periodic reassignment of account workload to address specific areas.
• Customer Service. Continually present a tactful, pleasant, and professional manner both verbal and in writing. Handle conflict situations diplomatically and achieve resolution. Understand the intent of the message and be able to communicate clearly, all to provide an exceptional experience, each time. Respond to all inquiries whether verbal or written in a prompt and timely fashion.

At NorthBay Health, our vision is to be the trusted healthcare partner of choice for the communities we serve. We are dedicated to improving the well-being of our community by providing accessible, high-quality care to all who need it. Every member of our team plays a vital role in delivering compassionate and effective healthcare solutions. We invite you to join us in our mission to ensure that every patient and family member feels valued, respected, and cared for throughout their healthcare journey.

Qualifications

Education:

• High school graduate or equivalent preferred.
• College courses with emphasis on Business preferred.

Experience:

• Three to five years of recent professional fee billing and collections experience, preferably in a multi-specialty practice environment required.
• Familiarity with use of CPT4, HCPCS and ICD-10 coding.
• Proficiency in Medicare, Medi-Cal and Commercial insurance plans, both HMO and PPO.
• Experience with UB-04 and/or HCFA 1500 claim forms billing.
• Experience in account follow up resolution for both electronic and manual claims.
• Demonstrated ability to effectively investigate, analyze and problem solve.
• Demonstrated service and success in teamwork and consistent high productivity and quality.

Skills:

• Ability to quickly master computer programs related to claims processing.
• Ability to understand the terms of payor contracts and fee schedules.
• Ability to understand Knox-Keene regulations as well as demonstrate an understanding of managed care concepts and terminology.
• Ability to effectively prioritize work, as well as the ability to process accounts quickly to meet deadlines.
• Ability to process claims accurately and timely.
• Ability to exercise appropriate, independent judgment and effectively solve problems.
• Knowledge of medical terminology.
• Ability to perform several different types of tasks each day and to adapt to changing priorities.
• Knowledge of personal computers with an emphasis on public folders, shared drives, Internet, and downloading and sorting spreadsheets and word processing programs required.

Interpersonal Skills:

• Demonstrates the True North values. The True North values are a set of value-based behaviors that are to be consistently demonstrated, and role modeled by all employees that work at NorthBay Health. The True North values principles consist of Nurture/Care, Own It, Respect Relationships, Build Trust and Hardwire Excellence. Ability to communicate effectively and pleasantly to members, providers, payors and internal staff is essential. A willingness to work as a team player with co-workers and other internal staff, as well as people outside NorthBay.

Hours of Work:

• 8 hours per day.
• Consistent attendance and work at the agreed upon hours of work is required.

Compensation:

• Hourly Salary Range Min $32.15 - Max $39.02 per hour (Offered hourly rate based on years of experience)

Work Location Requirement:

• This position may be performed onsite or remotely; however, onsite work is preferred based on business needs. Preference will be given to qualified candidates who are able to work onsite and are located within a reasonable commuting distance.

Remote Work Eligibility:

• This position is open to candidates located within the continental United States . Due to state-specific employment requirements and workers' compensation regulations, we are unable to support remote work arrangements in the following locations: Washington, Ohio, Wyoming, North Dakota, Puerto Rico, and the U.S. Virgin Islands.

About Us

Interpersonal Skills and Values

Demonstrates NorthBay Health's True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care.

Why NorthBay Health

NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.

We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions.

We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities.

NorthBay Health Benefits Options

NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance.

Compensation Structure

NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1-5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements.

Remote Work Disclosure

NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs.

Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States.

Notice to Recruitment Agencies

NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings.

More Information

Visit NorthBay Health Careers for recruitment FAQs and additional information.