Patient Account Representative II

Position Summary

Patient Account Representative II is responsible for billing, follow‑up, and collection of hospital patient accounts receivable. The role submits clean electronic and paper claims to payers, communicates by phone with internal and external contacts to resolve issues, takes payments, and uses assertive follow‑up techniques with third‑party payors for claim resolution, including adjustments for incorrect payments or denials.

• Education:
  
  High School Diploma or equivalent required.
• Experience:
  
  2–3 years of healthcare accounts receivable experience required. Prior hospital experience with insurance billing, follow‑up, contractual adjustments, Medicare/Medicaid, managed care preferred. Knowledge of Epic EHR preferred.
• Licensure/Certification/Registrations:
  None.
• Skills & Abilities:
  Excellent organization and customer service skills; ability to handle multiple priorities and meet deadlines; advanced verbal and written communication; high accuracy and attention to detail; problem‑solving and independent thinking; proficiency in Microsoft Word, Excel, web navigation, and patient accounting systems.

• Monitor contracts and individual patient agreements to ensure timely reimbursement.
• File claims timely, follow up on denials and non‑payment, and eliminate filing denials.
• Follow up on denials and communicate any denial issues related to billing requirements.
• Follow up on unpaid/unresolved account balances as required in the work queue and note follow‑up response on patient accounts.
• Resubmit claims, correct claims, medical records requests, and appeals as necessary to facilitate timely claims payment.
• Collaborate with Clinical Case Managers, Health Information Management, Admissions, and other hospital departments for account‑related issues.
• Investigate and respond to complex billing and collection inquiries; answer inquiries from patients and insurance companies to facilitate payment and correct claims.
• Post payments, process contractual adjustments, credit balances and refunds, research and resolve payment problems, and enter data into patient accounting systems.
• This job description is not exhaustive; the employee may perform other related duties as assigned.

Craig Hospital offers a comprehensive benefits package that includes self‑funded medical insurance administered by Allegiance Benefit Plans with a CIGNA network, dental and vision coverage through Delta Dental and Eye Med, Health Care and Dependent Care Spending Accounts, Short‑Term and Long‑Term Disability Insurance, generous time‑off benefits, a 403(b) retirement plan with matching contributions through Empower Retirement, Tuition Assistance, Employee Assistance Programs, and an Employee Emergency Assistance Fund.

Employees may tailor the benefits package to meet their individual needs.