Patient Account Representative II

Craig Hospital•Englewood, CO

20d•Onsite

About The Position

The Patient Account Representative II is responsible for billing, follow-up, and collections for hospital patient accounts receivable. The role submits clean electronic and paper claims to payers, communicates with internal and external contacts to resolve account issues, provides information, and takes payments. It uses assertive follow-up with third-party payors to resolve claims, including incorrect payments and denials. The position is in person at 3425 S Clarkson St, Englewood, Colorado, Monday through Friday, 8:00 a.m. to 4:30 p.m., with the possibility of working remotely one day per week. The listed pay range is $21.15 to $28.20 per hour. The representative ensures patient accounts are billed and monitored appropriately, follows up on claims and unpaid balances, and works with patients, insurers, and hospital departments to address account concerns. Duties include preparing, submitting, correcting, and appealing claims; reviewing reimbursement and contractual adjustments; processing payments, refunds, and credit balances; maintaining accurate patient-account documentation; and responding to billing inquiries. The role may also take on related duties as assigned.

Requirements

High school diploma or equivalent required.
Four to five years of healthcare accounts receivable experience required.
Excellent organization and customer service skills.
Ability to manage multiple priorities, prioritize and schedule work, and meet established deadlines.
Ability to communicate effectively with a variety of personnel.
Advanced verbal and written communication skills.
Ability to maintain a high degree of accuracy, dependability, and attention to detail.
Ability to think independently, solve problems, and adapt to multiple variables and circumstances.
Strong proficiency in Microsoft Word and Excel, web navigation, and patient accounting systems.
No licensure, certification, or registration required.

Nice To Haves

Previous hospital experience with insurance billing and follow-up, contractual adjustments, Medicare/Medicaid, and managed care is strongly preferred.
Knowledge of Epic EHR is preferred.

Responsibilities

Ensure proper billing of patient accounts, monitor accounts receivable, and contact third-party payors and patients to collect outstanding balances.
Monitor contracts and individual patient agreements to ensure appropriate reimbursement is received in a timely manner.
Meet timely filing requirements and follow up on claims to prevent timely-filing denials and nonpayment.
Follow up on denials and communicate billing-related denial issues proactively.
Follow up on unpaid or unresolved account balances in the work queue and document responses on patient accounts.
Resubmit claims and submit corrected claims, medical-record requests, and appeals as needed to facilitate proper payment.
Collaborate with Clinical Case Managers, Health Information Management, Admissions, and other hospital departments on account-related issues.
Investigate and respond to complex billing and collection inquiries.
Respond to patient and insurance-company inquiries and correspondence, make necessary corrections, and facilitate claims payment.
Post payments and notes to patient accounts; process contractual adjustments, credit balances, and refunds; research and resolve payment problems; and operate computerized patient-accounting systems.
Monitor self-pay accounts and balances, understand self-pay classifications and statement processes, and review self-pay credit balances for accuracy.
Handle special projects related to claim reimbursement and Medicare bad-debt write-offs.
Identify and resolve patient billing complaints and explain charges, EOBs, and payments.
Prepare and process UB04 and 1500 claim forms and itemized statements for insurers according to contractual requirements.
Maintain accurate information in the patient accounting system and spreadsheets used for reimbursement verification.
Document billing and collection actions in the patient accounting system.
Review EOBs for accurate contractual reimbursement and post contractual adjustments.
Track claim progress and contact payers to determine the status of unpaid claims; prepare appeal documents for claim disputes or payment issues.
Scan account-related documents in the patient accounting or document-management system.
Communicate with consulting physician offices and resolve credit balances as required by the work queue.
Provide requested billing records to Health Information Management and prepare medical-record requests for billing.
Follow hospital-wide and department-specific policies and procedures, seek management assistance when needed, and assist other staff members as requested.
Perform other related duties as assigned.

Benefits

Medical insurance with two comprehensive plan options and a CIGNA provider network.
Dental insurance through Delta Dental.
Vision insurance through EyeMed.
Health Care and Dependent Care Spending Accounts.
Short-Term Disability Insurance paid for by Craig Hospital for benefit-eligible employees.
Long-Term Disability Insurance paid for by Craig Hospital for benefit-eligible employees.
Generous time-off benefits.
403(b) retirement plan with a generous matching contribution, available upon hire.
Tuition assistance.
Employee Assistance Programs.
Employee Emergency Assistance Fund.