PATIENT ACCOUNT REP I

Stanford Health Care•Palo Alto, CA

2d•$32 - $36

About The Position

The Patient Account Representative (PAR) is responsible for timely and accurate processing of insurance-balance patient claims in accordance with contracts and policies. The role supports the Patient Financial Services business office’s goal of resolving unpaid, underpaid, denied, or unresolved patient accounts. Duties vary by team and may span several PFS operational areas. PAR I is an entry-level role performed under initial close supervision. The representative handles clearly defined, routine duties, responds to straightforward queries or issues, and recognizes when to refer or escalate issues.

Requirements

High school diploma or GED equivalent.
One year of directly related work experience.
Ability to follow oral and written instructions and accurately interpret institutional and other policies.
Clear and professional verbal and written communication skills.
Ability to maintain confidentiality of sensitive information.
Ability to perform basic mathematics.
Ability to plan, prioritize, and meet deadlines.
Ability to work effectively with individuals at all levels of the organization.
Knowledge of accounts-receivable software systems and medical billing operations.
Familiarity with medical reimbursement policies and procedures and medical terminology.
Knowledge of payer landscape, including Medicare, Medicaid, Workers’ Compensation, managed care, or other commercial insurance.
Ability to meet weekly individual productivity goals and standards while following planned priorities.

Responsibilities

Respond to payer requests by providing medical records or other documentation by mail or through payer portals.
Receive incoming business-office correspondence and distribute it appropriately.
Work in Epic to resolve work queues, locate documentation, and perform other follow-up or business-office activities.
Perform printing and mailing functions.
Edit and submit electronic or hardcopy claims to payers.
Perform basic claims follow-up involving denials, underpayments, or payer rejections.
Depending on team assignment, support accounts-receivable collections and payer follow-up; basic clerical denial review and request processing; payment posting and batch reconciliation; credit-balance review and resolution; retroactive eligibility and registration; underpayment reconciliation; or client and other special billing.
Meet weekly individual productivity goals and standards while following priorities set by the Team Manager.
Communicate professionally with PFS staff, payers, and patients regarding billing of services.
Follow oral and written instructions and accurately interpret institutional and other policies.
Maintain confidentiality of sensitive information, plan and prioritize work, and meet deadlines.