Patient Billing Call Center Representative

HighFive Healthcare•Birmingham, AL

About The Position

We are seeking a detail-oriented and empathetic Patient Billing Call Center Representative to join the Call Center team. This role is the primary point of contact for patients with questions about account balances, patient statements, insurance explanations of benefits (EOBs), payment options, and billing concerns. The representative helps patients understand what they owe, why they owe it, and how to resolve their balances while ensuring interactions are professional, accurate, and compliant. The role also includes reviewing denials, accounts receivable, payment posting, or initial reviews of patient statements when not answering calls.

Requirements

1–2 years of healthcare experience in a provider or payer setting, such as a hospital, physician practice, dental office, health plan, or medical billing environment.
Knowledge of patient statements, billing terminology, and the patient payment cycle.
Ability to read and understand insurance EOBs, including allowed amounts, adjustments, patient responsibility, and denial codes.
At least 1 year of call center or high-volume phone experience, preferably in billing, collections, or customer support.
Strong customer service skills and the ability to remain patient and professional in emotionally charged conversations.
Excellent verbal and written communication skills, including the ability to explain financial information clearly.
Proficiency with computer systems and the ability to navigate multiple applications while on calls.
Proficiency in navigating patient portals.
Strong attention to detail, organizational skills, and math accuracy.
Knowledge of HIPAA privacy and security requirements.
High school diploma or equivalent required.

Nice To Haves

Knowledge of Carestack.
Coursework or certification in medical billing, coding, or healthcare administration.
Bachelor’s degree.

Responsibilities

Answer a high volume of inbound patient billing calls promptly and with a patient, empathetic, and professional attitude.
Explain patient statements, including charges, adjustments, insurance payments, patient responsibility, and current balances.
Review and interpret insurance EOBs, explaining how allowed amounts, deductibles, copays, coinsurance, and denials affect patient balances.
Identify discrepancies between patient statements, EOBs, and account records, and research or escalate billing errors to the appropriate team.
Set up payment arrangements, process payments, and discuss financial assistance or payment plan options in accordance with company policy.
Document call activity accurately and thoroughly in patient accounts and the billing system.
Follow up on open billing inquiries and escalated issues to ensure timely resolution and patient satisfaction.
Maintain patient privacy and comply with HIPAA and company security and compliance standards.
Meet or exceed call-handling, resolution, and quality performance metrics.
Collaborate with billing, insurance, and clinical team members to support accurate account resolution and a seamless patient experience.
Review denials, accounts receivable, payment posting, or conduct initial reviews of patient statements when not answering calls.