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We are looking for a Patient Account Representative to join a healthcare team in California. The Patient Account Representative is great position for a medical biller looking to work for a hospital. The Patient Account Representative will be tasked with medical billing and collections and manage accounts across a range of payer types. The Patient Account Representative role focuses on resolving outstanding balances, addressing denials and appeals, and supporting timely reimbursement for both inpatient and outpatient services.
Job Responsibility:
Pursue outstanding hospital accounts by following up with insurance carriers and other payers to secure accurate and timely payment
Investigate claim denials, underpayments, and delayed reimbursements, then take appropriate action to move accounts toward resolution
Prepare and submit appeals with supporting documentation to challenge payer decisions and recover eligible revenue
Work across multiple coverage categories, including Medicare managed care, commercial plans, and managed care products, to address billing and collection issues
Review inpatient and outpatient account activity to identify discrepancies, correct billing issues, and escalate complex cases when needed
Maintain detailed records of collection efforts, account updates, and payer communications in accordance with departmental standards
Collaborate with internal billing and revenue cycle teams to resolve account barriers and improve reimbursement outcomes.
Requirements:
At least 3 years of experience in hospital billing and collections
Hands-on knowledge of medical billing, medical collections, denials, and appeals processing
Experience working with a variety of payer types, including Medicare managed care, commercial insurance, and managed care plans
Understanding of hospital revenue cycle workflows for both inpatient and outpatient accounts
Familiarity with HMO and PPO reimbursement structures and related follow-up practices
Strong attention to detail with the ability to prioritize a high volume of accounts effectively
Clear written and verbal communication skills for interacting with payers and internal teams.