Patient Account Representative II - Patient Billing Services

HonorHealth•Phoenix, AZ

1d•Onsite

About The Position

The Patient Account Representative II supports timely reimbursement to medical providers by performing billing and collections, account research, correspondence, payment and adjustment posting, charge entry, prior authorization, and related duties. The role requires independent problem-solving to resolve account errors and bring balances to zero within established time frames. Responsibilities include researching insurance accounts and securing payment; following up on assigned accounts and denials; submitting appeals; contacting insurers and patients about insurance-related issues; researching recoups and repayments; and reviewing denial and charge-review work queues. For patient balances, the representative follows up on assigned accounts, sends final letters, answers patient calls, collects past-due balances, processes payments, establishes payment plans, reviews statements, and addresses account disputes and returned mail. The position also performs claim data entry and review, including entering physician charges, resolving claim edits and denials, maintaining knowledge of payer billing requirements, and processing electronic and paper claims. It handles payments and correspondence through channels such as EFT/ERA, lockbox, mail, point of sale, phone, and credit card; creates payment batches; processes deposits and refunds; reconciles batches; and researches credit and adjustment issues. The representative prioritizes work, participates in huddles, meetings, and training, provides customer service to patients and colleagues, maintains organized records and work areas, communicates effectively, and works collaboratively while managing multiple tasks. Other duties may be assigned.

Requirements

High school diploma or GED.
Two years of healthcare billing and collections experience in a medical practice or healthcare organization.
Professional medical insurance billing and collections experience, including working denials, is stated in the posting summary as a minimum of three years.

Nice To Haves

Five years of healthcare-related medical professional billing and collections experience.

Responsibilities

Research insurance accounts and secure payment, following up on assigned accounts to reduce accounts receivable.
Submit appeal letters for unpaid or underpaid claims and contact insurance companies regarding denials and correspondence.
Contact patients regarding insurance-related issues and research recoups and repayments for accuracy and compliance with applicable payment methodologies.
Work electronic denial files and review assigned charge-review work queues.
Follow up on patient-balance accounts, send final letters, answer incoming patient calls, and make collection calls for past-due balances.
Process and post patient payments, set up payment plans, review statements, and address patient account complaints and disputes.
Support clinics as needed during patient care hours and liaise among patients, practices, and insurance carriers.
Work with statement and bad-debt vendors on disputes, and process returned mail to update account information.
Enter physician billing charges, correct claim-edit denials, maintain knowledge of payer requirements, process electronic claims, and initiate printing of paper claims.
Handle payments and correspondence received by the central business office, including EFT/ERA, lockbox, mail, point-of-sale, phone, and credit-card payments.
Create payment batches, scan correspondence into the patient billing system, process deposits, and post payments and denials.
Process ERA payments, work error queues, reconcile daily batches, and manage credit work queues, refunds, and incorrect adjustments or payments.
Prioritize work to support efficient collections, participate in daily huddles, department meetings, and training, and provide five-star customer service.
Maintain an efficient filing system and an organized work area; communicate effectively, work collaboratively, accept constructive feedback, and manage multiple tasks flexibly.
Perform other duties as assigned.