Account Representative

• Schedule - Shift - Hours Full Time - Day Shift: Monday - Friday

National Jewish Health is seeking a dedicated and detail‑oriented Account Representative to support the Patient Financial Services team. This on‑site role, based in Glendale, Colorado, plays an important part in ensuring accurate processing of accounts receivable, consistent follow up on outstanding claims, and strong service for both patients and payors. Candidates for this position should be approachable, knowledgeable, motivated, and able to problem solve effectively.

• Supports patient accounts receivable through billing, claim follow up, appeals, and account resolution
• Applies working knowledge of medical reimbursement policies, medical terminology, and insurance claim procedures
• Demonstrates familiarity with Medicare, Medicaid, Workers Compensation, Managed Care plans, and Commercial Payors
• Provides attentive customer service and patient advocacy while resolving standard questions and issues
• Uses sound judgment to address moderately complex account matters and recommend appropriate next steps

National Jewish Health is the leading respiratory hospital in the United States and has been recognized for excellence since opening its doors in 1899. With a focus on comprehensive care, academic advancement, and innovative research, the organization continues to shape the future of preventive and personalized medicine.

Responsible for financial resolution of receivables by verifying appropriate reimbursement for services rendered. Achieves by persuasive collection techniques, problem solving, complex mathematical proficiency, resolving eligibility, insurance claims billing, insurance claim follow up and/or other related obstacles, according to the existing procedures for collection and by utilizing all available patient accounting and/or payor software.

• Has a thorough understanding of CPT, HCPCS & ICD‑10 codes, HCFA and UB04 claim forms, DRG, insurance benefits including authorizations/referrals.
• Works daily with automated worklist, ATB and or assigned special projects in the patient accounting system to perform account audits of insurance and patient payments. Utilizes claims editing software and/or payor software to review claims history in order to address and resolve payment delays and/or incorrect payments.
• Maintains ability to read and comprehend all payors’ claims adjudication vouchers, explanation of benefits (EOB), or electronic remittance advice (ERA). Utilizes vouchers, EOBs, and ERAs to help confirm proper processing of claims and appropriate levels of reimbursement.
• Maintains a current and thorough knowledge of regulatory and procedural requirements related to the assigned account workload. Knowledge of applicable contracted payor documents including the contract matrix and state and federal regulations are required. Regulations include but are not limited to various reimbursement methodologies depending on the services billed and claims editing content.
• Contacts insurance companies or clients and uses proper negotiation or persuasion techniques to elicit payment promise or account resolution. When necessary, works with billers to perform re‑bills or secondary billing. Calendars follow up collection calls and activities, according to existing procedures in order to meet personal productivity and departmental receivable goals.
• Performs appeals of insurance denials and/or incorrect reimbursement. Facilitates medical record documentation submissions when medical necessity is the basis for denial and other required documentation when expected reimbursement is not received.
• Processes all refunds, payment transfers and adjustments for account workload according to established Patient Financial Services (PFS) policies.
• Contacts patients when necessary to elicit claims and account resolution. Demonstrates good customer service and is knowledgeable when contacting patients.
• Identifies self‑pay accounts and potential bad debt accounts for referral to outside agencies or attorneys for further collection efforts.

• Communicates regularly with PFS Supervisor or Manager regarding high‑risk accounts.
• Responds…