Patient Account Representative II - Patient Billing Services

HonorHealth•Phoenix, AZ

About The Position

The Patient Account Representative II is responsible for billing and collections, account research, correspondence, payment and adjustment posting, charge entry, prior authorization, and related duties to support timely reimbursement to medical providers. The role requires independent problem-solving to resolve account errors and bring balances to zero within established time frames. The representative researches and secures payment for insurance accounts and patient balances, follows up on assigned work queues, addresses denials and underpayments, and communicates with insurers and patients. The role also handles claim edits, charge entry, electronic and paper claims, payments and correspondence, deposits, batch reconciliation, credit work queues, refunds, and account accuracy. The representative provides customer service to patients, coworkers, vendors, clinics, and management; participates in team and department activities; and performs other duties as assigned.

Requirements

High school diploma or GED.
At least 2 years of healthcare billing and collections experience in a medical practice or healthcare organization.
Ability to independently research and resolve account errors within established time frames.
Ability to handle multiple tasks with flexibility and work effectively in a team environment.

Nice To Haves

5 years of healthcare-related medical professional billing and collections experience is preferred.
Three years of experience in professional billing, insurance, and collections, including working denials, is preferred.

Responsibilities

Research insurance accounts and secure payment by following up on assigned daily accounts and work queues.
Submit appeal letters for unpaid or underpaid claims and participate in accounts receivable collection projects.
Contact insurance companies regarding denials and correspondence, and contact patients about insurance-related issues.
Research recoups and repayments to confirm accuracy and compliance with Medicare and managed care payment methodologies.
Work the electronic denial file (835b) to support clean claim submission and review assigned charge review work queues.
Follow up on patient balance accounts, submit final letters to delinquent accounts, answer incoming patient calls, and make collection calls for past-due balances.
Provide support to clinics during patient care hours and act as a liaison among patients, practices, and insurance carriers regarding complaints and problems.
Process and post credit card payments, establish patient payment plans, and review statements for accuracy.
Work with statement and bad-debt vendors to resolve disputes and ensure account accuracy; process return mail and update accounts.
Enter physician billing charges, correct denials in claim-edit work queues, maintain knowledge of payer billing requirements, and process electronic claims batches and paper claims.
Process EFT/ERA, lockbox, mail, point-of-service, and phone payments; create payment batches and scan correspondence into the patient billing system.
Process deposits for incoming payments, arrange courier service for new clinics, post payments and denials, process ERA payments, and work error queues.
Perform daily batch reconciliation and follow up on credit work queues, including undistributed credits, refunds, and research into incorrect adjustments or payments.
Prioritize work to improve collections efficiency, participate in daily DMS huddles and department meetings, and provide five-star customer service.
Maintain an efficient filing system and an organized work area; communicate effectively, participate in training, work collaboratively, accept constructive feedback, and handle multiple tasks flexibly.
Perform other duties as assigned.