Patient Account Representative II (Remote)

Stanford Health Care

2d•$34 - $38•Remote

About The Position

The Patient Account Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. The PAR works in various capacities to support the primary goal of the business office to resolve of unpaid, underpaid, denied or unresolved patient accounts. Depending on the specific team, the PAR's focus may be on a mix of various responsibilities from across the Patient Financial Services (PFS) operations. Responsibilities may include: Accounts receivable collections and payer follow-up, Payer clerical and technical denial review and request processing including basic appeals, Payment posting and batch reconciliation, Credit balance review and resolution, Retroactive eligibility and registration, Underpayment reconciliation, Client or other special billing. The PAR II works primarily in Epic, under general supervision, to perform the full range of duties for assigned class. This role requires a strong working knowledge of systems and processes. A PAR II is expected to resolve standard queries and problems independently and works on assignments that are moderately complex in nature where critical thinking is required.

Requirements

High school diploma or GED equivalent
Two (2) years of progressively responsible and directly related work experience
Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager
Can maintain professional communication with various PFS staff, payers, and patients regarding the billing of services.
Ability to follow oral and written instructions and interpret institutional and other policies accurately
Ability to communicate clearly and professionally both verbally and in writing
Ability to maintain confidentiality of sensitive information
Ability to perform basic mathematics
Ability to plan, prioritize, and meet deadlines
Ability to work effectively with individuals at all levels of the organization
Knowledge of accounts receivable software systems and medical billing operations
Familiarity with medical reimbursement policies and procedures and medical terminology
Knowledge of payer landscape, including Medicare, Medicaid, Workers’ Compensation, Managed Care, or other Commercial insurance

Responsibilities

Responding to requests from the payer, such as providing medical records or other documentation either by mail or via payer portals
Following up on unresolved patient accounts in Epic by contacting the payer by phone or via the portal
Resolving claim edits
Reviewing payer variances and pursuing underpayments to payers
Reviewing and resolving payer rejections, denials, and performing appeals as necessary
Electronic or hardcopy claims editing and submission to payers
Recognizing potential trends and escalating them as appropriate
Posting payments in Epic, as well as related adjustments
Resolving credit balances
Completing basic charge corrections