Patient Account Representative

Patient Account Representative

Immediate need for a talented Patient Account Representative. This is a 13 months contract opportunity with long-term potential and is located in Pomona, CA (Onsite).

Key Responsibilities:

• Review accounts receivable aging reports and prioritize collection activities
• Follow up with insurance carriers regarding outstanding hospital claims
• Perform collections and follow-up for institutional (UB-04) facility claims
• Investigate, correct, and appeal denied or underpaid claims to maximize reimbursement
• Coordinate with billing and other internal departments to resolve claim discrepancies
• Accurately document all collection and follow-up activities in the billing system
• Verify patient insurance eligibility through payer websites, insurance portals, and customer service representatives
• Maintain compliance with HIPAA, organizational policies, and applicable state and federal regulations

Key Requirements and Technology Experience:

• Experience with Hospital Accounts Receivable (AR)
• Experience with Healthcare/Medical Collections
• Experience with UB-04 (Institutional/Facility) Claims
• Experience with Inpatient & Outpatient Collections
• Experience with Insurance Follow-Up / Facility Claims
• 1-3 years of experience in hospital accounts receivable, medical collections, or healthcare collections
• Required experience with both inpatient and outpatient collections
• Experience handling UB-04 (Institutional/Facility) claims
• Experience collecting facility claims across multiple lines of business
• Working knowledge of hospital billing processes, CPT, ICD, and DRG reimbursement methodologies
• Familiarity with Medicare, Medicaid/Medi-Cal, and commercial insurance payer guidelines
• Strong communication and negotiation skills for interacting with insurance payers
• Proficiency with hospital billing/follow-up systems and Microsoft Office
• Excellent analytical skills with the ability to identify claim denials, payment variances, and reimbursement opportunities
• Strong attention to detail and organizational skills
• High School Diploma or GED required