Patient Account Rep Follow-Up

Job Description

Job Description

Job Title: Patient Account Representative – Claims Follow-up & Revenue Cycle

Job Summary: We are seeking an experienced Patient Account Representative (Claims Follow-up & Revenue Cycle) to join our healthcare billing team. In this role, you will be responsible for cash posting, managing hospital billing claims, following up on unpaid or denied claims, resolving underpayments, verifying patient insurance eligibility, and communicating directly with major commercial insurance payers and patients to ensure timely account resolution.

Key Responsibilities:

• Claims Follow-up & Resolution: Monitor and follow up on outstanding hospital billing claims, investigate denials, address underpayments, and resolve account balances in a timely, accurate manner.
• Cash Posting & Eligibility: Accurately post patient and insurance payments to patient accounts and perform insurance eligibility verifications.
• Payer Communication: Interact with major commercial insurance payers (including Aetna, UnitedHealthcare, Horizon, and IBX) regarding claims status, Coordination of Benefits (COB) issues, and reimbursement appeals.
• Patient Financial Services: Communicate professionally with patients and insurance representatives regarding deductibles, co-pays, coverage determinations, and billing inquiries, delivering excellent customer service.
• Account Optimization: Ensure medical billing workflows adhere to compliance guidelines and internal revenue cycle performance targets.

Qualifications & Requirements:

• Education: High School Diploma or Equivalent [Required] .

• Billing Experience:

  • Minimum 2–3 years of hands-on hospital billing and revenue cycle experience [Required] .
  • Demonstrated proficiency in cash posting, claims follow-up, and denial management [Required] .
• Payer Knowledge: Solid understanding of commercial insurance processes, claim guidelines, and COB protocols [Required] .
• Core Competencies: Strong analytical and problem-solving skills, high efficiency in account resolution, excellent customer service demeanor, and strong communication skills.