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Role Description

The Patient Account Representative I performs a variety of revenue cycle activities including billing, collections, cash posting, and customer service in support of hospital and physician accounts. This position ensures accurate and timely financial documentation and reimbursement through effective communication with patients, insurance companies, and other stakeholders. The representative maintains compliance with all regulations including HIPAA, and adheres to organizational policies and procedures.

• Accurately and efficiently processes patient accounts, including billing, collections, and payment posting.
• Responds to and resolves inquiries from patients, insurance carriers, and internal departments.
• Prepares and submits claims using billing systems; works claim edits and rejections.
• Follows up on unpaid accounts and performs collections activities as appropriate.
• Researches and applies unidentified payments.
• Balances daily cash posting and reconciles discrepancies.
• Files appeals and reconsideration requests as per department protocol.
• Identifies and reports overpayments; ensures appropriate refunds.
• Participates in A/R clean-up projects and other revenue cycle initiatives.
• Maintains productivity and quality standards while managing daily work queues.
• Demonstrates ownership and accountability in completing assignments.

Qualifications

• Ability to communicate effectively, both verbally and in writing.
• Ability to work independently with minimal supervision.
• Strong customer service and interpersonal skills.
• Basic general accounting and bookkeeping knowledge.
• Knowledge of medical billing practices and medical terminology.
• Proficient in Microsoft Excel, Word, Outlook, and experience with systems such as Epic and SSI (preferred).
• Operates 10-key pad efficiently (for cash posting roles).
• Demonstrates flexibility and teamwork across all business office functions.

Requirements

• High School Diploma or GED Equivalent.
• Relevant licensure and practices obtained within timeframe required by facility policy.
• 1–2 years previous hospital and/or physician business office experience preferred.