Patient Accounts Rep 3

The Doctors Clinic • Silverdale, WA

1h • $21 - $30

About The Position

The Patient Accounts Representative III – Insurance Billing ensures a high level of customer service in patient accounts, including billing, collections, and billing adjustments. The role ensures billing follows clinic procedures and standards; audits claims and corrects missing data before submission; follows up with insurers on payment, denials, reimbursement accuracy, and documentation; and monitors payer turnaround times and aging claims. The position investigates billing problems, initiates refund requests for incorrect insurance payments, and works with Patient Accounts Representative IVs and/or the Coding and Compliance Department to address denials, payment delays, and downcoding. The representative must understand and be able to perform the duties of Patient Accounts Representative I and II, and may cross-train in the Patient Accounts III-Customer Service position.

The role also prioritizes and completes work promptly, assists office personnel as assigned, maintains confidentiality, documents processes, and collaborates with the business office and other departments. This position is represented by a collective bargaining agreement. Starting offers depend on directly applicable experience and internal equity within the paygrade. The stated wage range is $20.04–$29.02, with possible additional premiums as outlined in the CBA. Benefit eligibility depends on FTE, job classification, and applicable union agreements.

Requirements

• High school diploma or equivalent.
• Minimum 3 years of customer service experience.
• Minimum 2 years of experience in medical billing practices.
• Medical terminology knowledge.
• Basic computer and keyboarding skills.
• Ability to communicate clearly, concisely, and professionally in English in person, by phone, and in writing.
• Ability to resolve problems with minimal assistance and use sound judgment to implement corrective action.
• Strong organizational and interpersonal skills.
• Experience with conflict management.
• Excellent verbal communication skills and ability to independently write correspondence for patients, insurance companies, or other third parties.
• Ability to professionally represent clinic interests and patient concerns with external parties.
• Ability to provide leadership to groups.
• Ability to multitask efficiently and effectively.
• Knowledge of coding and clinical operating policies and procedures.
• Ability to prepare and examine documents for accuracy and completeness and correct errors.
• Ability to act calmly and effectively in busy or stressful situations.
• Adherence to policies and procedures, including safety, attendance, punctuality, and personal appearance standards.
• Ability to establish and maintain effective working relationships with managers and peers.
• Adequate hearing to perform duties in person and over the telephone.
• Ability to speak clearly with patients and coworkers in person and over the telephone.
• Visual acuity adequate to read printed information and computer screens.
• The position is mostly seated, with occasional standing and walking; frequent lifting and carrying of items under 5 pounds; occasional lifting and carrying of items up to 10 pounds; and occasional bending and reaching.

Nice To Haves

• CPC certification preferred.

Responsibilities

• Ensure billing follows applicable clinic procedures and standards.
• Identify and correct missing data before claim submission and audit claims in the electronic system.
• Maintain working knowledge of contracted health plans and identify resources to resolve complex questions and problems.
• Follow up with insurance companies to ensure claims are paid.
• Monitor reimbursements for accuracy against contracted payment rates and regulations.
• File timely appeals for denied claims, insufficient payments, or overstated disallowed amounts.
• Re-file claims with supporting documentation when needed to obtain higher reimbursement.
• Respond to carrier requests for information, including contacting practices for documentation supporting claim resubmission.
• Review audit reports to ensure payments are posted accurately.
• Investigate billing problems and formulate solutions for review and implementation.
• Initiate refund requests for incorrect insurance payments.
• Monitor payer reimbursement turnaround times of 30–45 days and report inconsistencies to insurers and the manager.
• Identify claim-payment slowdowns, notify the manager, and assist with corrective action.
• Maintain appropriate aging levels for assigned insurance types and take corrective action to prevent claims from becoming untimely.
• Work with Patient Accounts Representative IVs and/or the Coding and Compliance Department to address causes of denied claims, payment delays, and downcoding.
• Understand and be able to perform the duties of Patient Accounts Representative I and II; may cross-train in the Patient Accounts III-Customer Service position.
• Prioritize incoming work and complete it in a timely manner.
• Assist other office personnel as assigned and as workload permits.
• Maintain confidentiality of sensitive information.
• Collaborate constructively with the business office and other departments.
• Document work processes as required.
• Perform other duties as assigned.

Benefits

• Medical, dental, and vision insurance for eligible FTEs.
• Health Savings Account (HSA) or Health Reimbursement Arrangement (HRA).
• Paid holidays, Paid Time Off (PTO), and Long Term Illness (LTI) Leave.
• 401(k) retirement plan and profit sharing.
• Group life, Accidental Death & Dismemberment (AD&D), and Long-Term Disability (LTD) insurance.
• Possible weekend, shift, and other premiums outlined in the collective bargaining agreement.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED