Patient Account Representative II / Biller

HHC•Indianapolis, IN

About The Position

The Patient Account Representative II/Biller provides timely and accurate billing to support optimized reimbursement, research, and performance improvement. The role verifies billing data for accuracy and completeness, follows regulatory requirements, and resolves edits or exceptions identified during claim processing in patient accounting systems, claim-editing systems, or by payors. This includes reviewing medical and facility documentation and addressing payor denials, appeals, and credit balances. The representative works assigned hospital accounts through resolution, including low-balance credit accounts and claim edits. The role also supports billing and collection processes across departments, identifies trends in payor rejections and denials, contributes to process improvements, and maintains accurate records and reconciliations. The position is full-time on the day shift.

Requirements

Two years of accounts receivable experience in a hospital billing environment, or two to three years of experience in a financial institution in lieu of formal education.
Knowledge of federal, state, and regulatory billing code sets and the ability to follow organizational policies and procedures and Indiana State Department of Health regulations.
Ability to use support systems such as Epic, OnBase, NThrive, and other software applications.
Knowledge of the Epic Patient Accounting system.
Computer key-entry skills and ability to operate a calculator.
Ability to research and identify payor billing and reimbursement guidelines.
Strong oral and written communication skills, including the ability to present information to clinical and non-clinical staff.
Customer service skills, professionalism, ethical behavior, and a team-oriented, solution-driven approach to problem solving.
Knowledge of reimbursement methodologies, payor coverages, state and federal healthcare benefit and payment programs, and assigned payor billing requirements and regulations.
Ability to learn software quickly, interpret instruction manuals, and use payer and hospital patient accounting systems.
Ability to complete tasks within given time frames and remain productive and goal oriented.
Ability to work independently and with a team, follow instructions, and collaborate effectively to address problems.
Knowledge of healthcare procedure codes and Uniform Billing standards.
Ability to multitask in a fast-paced environment.
Strong interpersonal, problem-solving, and analytical skills.

Nice To Haves

Associate degree in a business-related field preferred.
Previous denial management experience with Medicare, Medicaid, and insurance.
Previous experience billing Medicare, Medicaid, and insurance.
Medical billing and coding certification.
Ability to lead, supervise, and motivate personnel.

Responsibilities

Resolve low-balance hospital account credit balances in accordance with federal and state requirements and turnaround guidelines.
Serve as a resource to other departments to resolve problems and expedite billing and collection processes.
Resolve claim edits for low-dollar hospital accounts in accordance with payor guidelines and regulations.
Identify and trend payor rejections and denials and implement process improvements to prevent future occurrences.
Respond to emails and voicemails in a timely manner.
Assist with special projects and provide coverage for team members who are out of the office.
Stay current on billing and collection rules, regulations, contract terms, timely filing requirements, and service pre-certification and authorization requirements.
Contact patients and insurance companies to obtain information needed to resolve accounts.
Update job knowledge through educational opportunities and professional publications.
Work efficiently under pressure, act independently, and accept responsibility for decisions.
Participate in monthly staff meetings and educate colleagues about payor practices as needed.
Complete payor appeals related to underpayment, timely filing, medical necessity, and prior authorizations.
Work proactively with departments to resolve billing issues, Do Not Bill errors and warnings, and claim edits.
Review and maintain accounts receivable denials to meet or exceed key performance indicators, including AR days under 35, credit-balance days under one day of AR, denial days under one day of AR, and billing outstanding claims within seven days of system errors.
Work with management when contract variances are identified.
Work assigned patient accounts with credit balances and claims through resolution.
Enter required information accurately in management systems.
Complete refund packets in the OnBase imaging system and maintain a weekly spreadsheet of processed refunds.
Research and resolve patient revenue balancing and posting issues across multiple systems.
Reconcile all transactions within the patient accounting system.