Patient Access Representative

Patient Access Representative

Location: Pomona, CA (91767) Duration: 13 Weeks

Shift Details:

1. Day Shift: Monday Friday (5x8 Hours)
2. Timing: (7:00 am 3:30 pm; 7:30am 4:00pm; 8:00 am 4:30pm; 8:30 am 5 pm)

Required Qualifications:

• High School Diploma or GED Required
• 13 years in hospital accounts receivable, medical collections follow up, or healthcare collections.

Required Skills:

• 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.