Patient Accounts Representative - Monday-Friday - Day Shift

Patient Accounts Representative

The Patient Accounts Representative is responsible for the timely, accurate, and compliant processing of healthcare claims and the ongoing management of patient accounts receivable. This position performs insurance billing, claims submission, payment and denial follow-up, account reconciliation, and resolution of outstanding insurance balances for hospital and professional services.

The Patient Accounts Representative is responsible for maintaining assigned payer accounts, identifying and resolving billing discrepancies, researching claim rejections and denials, and ensuring claims are processed in accordance with federal and state regulations, payer-specific guidelines, contractual requirements, and Missouri Delta Medical Center policies and procedures.

This position requires working knowledge of healthcare revenue cycle processes, insurance reimbursement methodologies, UB-04 and CMS-1500 claim forms, and governmental and commercial payer requirements. The representative must demonstrate accountability for assigned work queues, maintain accurate and thorough account documentation, meet established productivity and quality expectations, and proactively identify opportunities to prevent recurring billing errors and reimbursement delays.

The Patient Accounts Representative reports directly to the Revenue Cycle Director or designated leadership and is expected to work independently while maintaining effective communication and collaboration with other departments, insurance carriers, patients, and external business partners.

Functions of Position:

• Insurance Billing and Claims Submission
• Insurance Follow-Up and Accounts Receivable Management
• Denial Management and Appeals
• Payment Review and Account Reconciliation
• Governmental and Commercial Payer Compliance
• Account Documentation and Communication
• Departmental Productivity, Quality, and Accountability
• Professional Conduct and Organizational Responsibilities

Qualifications:

• Education: High school diploma or equivalent required. Additional education in medical billing, coding, healthcare administration, or business administration preferred. Medical billing and/or coding certification is preferred.
• Experience: Minimum of six months to one year of experience in healthcare claims billing, medical accounts receivable, insurance follow-up, or a related revenue cycle position required. Experience with hospital or physician billing preferred. Experience working with Medicare, Medicaid, and commercial insurance payers preferred. Experience with electronic health records, patient accounting systems, clearinghouses, and payer portals preferred.
• Knowledge and Skills: Working knowledge of healthcare revenue cycle processes and insurance claims management. Understanding of UB-04 and CMS-1500 billing requirements. Familiarity with CPT, HCPCS, ICD-10-CM, revenue codes, modifiers, and medical terminology. Knowledge of Medicare, Medicaid, and commercial insurance billing guidelines. Ability to interpret EOBs, ERAs, denial codes, and payer correspondence. Strong analytical, organizational, and problem-solving skills. Excellent verbal and written communication skills. Ability to manage multiple priorities and meet established deadlines. Ability to work independently with minimal direct supervision. Proficiency in Microsoft Office applications and general computer navigation. Ability to adapt to changing payer regulations, billing requirements, and departmental workflows. Demonstrates professionalism, initiative, accountability, and attention to detail.

Work Location: On-site in Sikeston, Missouri

Day shift, Monday-Friday