Patient Account Representative II - Patient Billing Services

HonorHealth•Phoenix, AZ

14h•Onsite

About The Position

The Patient Account Representative II is responsible for some or all aspects of medical-provider reimbursement, including billing and collections, account research, correspondence, payment and adjustment posting, charge entry, and prior authorization. The role requires independently identifying and resolving account errors to bring balances to zero within established time frames. The representative researches insurance accounts and pursues payment through account follow-up, appeals, denial resolution, and communication with insurers and patients. The role also researches patient balances, handles patient inquiries and collections, processes payments and payment plans, reviews statements, and coordinates among patients, practices, and insurance carriers. Additional duties include charge and claim processing, maintaining knowledge of payer billing requirements, processing and reconciling incoming payments and correspondence, managing credit work queues and refunds, and supporting departmental operations and customer service.

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 numerous tasks simultaneously and work with flexibility.
Effective communication, customer-service, and teamwork skills.

Nice To Haves

5 years of healthcare-related medical professional billing and collections experience is preferred.
Experience in professional billing, insurance, collections, and denial work is preferred.

Responsibilities

Follow up on assigned insurance accounts to reduce accounts receivable and secure payment.
Submit appeal letters for unpaid or underpaid claims and contact insurers regarding denials and correspondence.
Contact patients about insurance-related issues and past-due balances; answer incoming patient calls and provide clinic support during patient-care hours.
Research recoupments and repayments to verify payment accuracy and compliance with Medicare and managed-care contract methodologies.
Work the electronic denial file (835b) to support clean claim submission and review assigned charge-review work queues.
Submit final letters to delinquent patient accounts, process credit-card payments, establish payment plans, and review statements for accuracy.
Act as a liaison among patients, practices, and insurance carriers regarding complaints and problems.
Coordinate with statement and bad-debt vendors on disputes; work return mail and update account information.
Enter physician charges, correct claim-edit denials promptly, process electronic claim batches daily, and initiate printing of paper claims.
Maintain current knowledge of regulatory billing requirements for specified payers and specialty-specific limitations or expectations.
Process EFT/ERA, lockbox, mail, point-of-service, phone, and credit-card payments; create payment batches and scan correspondence into the patient billing system.
Process deposits from incoming payments, including point-of-service payments from multiple clinics; arrange courier service for new clinics.
Post payments and denials, process ERA payments, and work the error queue.
Perform daily batch reconciliation and follow up on credit work queues, including undistributed credits, refunds, and research of incorrect adjustments or payments.
Prioritize work to support efficient collections and participate in daily DMS huddles and department meetings.
Provide five-star customer service to patients, coworkers, vendors, and management; maintain an organized work area and efficient filing system.
Communicate and engage effectively, participate in training and constructive feedback, and work flexibly in a team environment while handling multiple tasks.
Perform other duties as assigned.