Patient Account Representative

It's more than a career, it's a calling.

MO-REMOTE

Worker Type:

Regular

Job Highlights:

Do you have experience resolving hospital claim denials or managing denials on the insurance/payer side? Join SSM Health's Patient Accounts team and play a critical role in ensuring patients receive the coverage and support they need. In this position, you'll investigate, appeal, and resolve denied claims, work directly with payers, and help secure reimbursement for services provided across our health system. Your expertise will directly contribute to financial stewardship, operational success, and an exceptional patient experience.

What We're Looking For

• Experience reviewing, appealing, and resolving hospital claim denials

• Experience processing/managing denials on the insurance or payer side

• Strong knowledge of insurance billing, reimbursement, and denial management processes

Schedule

• Full Time | Monday-Friday

• Start time between 7:00 AM and 8:30 AM; shifts end by 5:00 PM.

Location

• Remote - Candidates must reside in Missouri, Illinois, Oklahoma, or Wisconsin.

Job Summary:

Responsible for processing patient accounts. Duties may include one or more of the following: processing insurance payments, following up on denied claims, and resolving credit balances. Typically works in no more than two functional areas.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

• Processes the insurance component of a patient's obligation using the third party claims processing and payment rules. Bills claims appropriately.

• Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines and no response claims to resolve outstanding accounts.

• Analyzes credit balances on patient accounts and resolves. Responds to refund request letters from insurance carriers.

• Performs other duties as assigned.

EDUCATION

• High school diploma or equivalent

EXPERIENCE

• No experience required

• Direct experience with hospital claim denials or managing denials on the insurance/pay sideo specialized Due to the current needs and specialize nature of this role, applicants with preferred denial management experience will receive priority consideration

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.

• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.

• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.

• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.

• Frequent keyboard use/data entry.

• Occasional bending, stooping, kneeling, squatting, twisting and gripping.

• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.

• Rare climbing.

Department:

8701000033 RCO Strategy and Culture

Work Shift:

Day Shift (United States of America)

Scheduled Weekly Hours:

40

Benefits:

SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.

• Paid Parental Leave : we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).

• Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.

• Upfront Tuition Coverage : we provide upfront tuition coverage through FlexPath Funded for eligible team members.

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SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status , or any other characteristic protected by applicable law. Click here to learn more. (