Non-Clinical - Administrative - Patient Services Representative

Patient Services Representative

Location: Pomona, CA (91767)

Duration: 13 weeks

Working Schedule: Day Shift || Monday through Friday (8:30 AM to 5:00PM)

Job Summary:

• Responsible for scheduling patients and providing administrative support in a hospital or medical office setting.
• Review hospital accounts receivable aging reports and prioritize collection efforts.
• Contact insurance carriers to collect outstanding balances and resolve issues.
• Follow up on institutional claims (UB04).
• Investigate and appeal denied or underpaid claims to maximize reimbursement.
• Coordinate with other departments, such as the billing team, to resolve discrepancies.
• Document all collection activities in the hospital’s system.
• Ensure compliance with HIPAA, hospital policies, and state/federal regulations.
• Obtain eligibility through websites, insurance portals, and insurance customer service.

Responsibilities:

• Knowledge of hospital billing processes, CPT/ICD codes, and DRG reimbursement.
• Familiarity with payer guidelines such as Medicare, Medi-call and commercial payers.
• Strong communication skills for payer interactions.
• Proficiency in hospital billing systems and Microsoft Office.
• Attention to detail and ability to analyze claim denials and payment variances.

Experience:

• 1–3 years in hospital accounts receivable, medical billing, or healthcare collections.

Education:

• High school diploma or GED required.