Job Purpose:

We are seeking a versatile and detail-oriented Patient Account Representative who will manage both medical and legal billing processes within our healthcare organization. The ideal candidate will ensure accuracy, compliance, and timely resolution of accounts receivable for medical services. The role requires proficiency in medical billing software, strong analytical skills, and excellent communication abilities to interact effectively with healthcare providers, legal professionals, and patients. An experienced Patient Account Representative is responsible for expedient collection of payment at the highest level of reimbursement allowed for the medical services proved for assigned accounts. The representative ensures the company receives payment for services provided and resolves discrepancies.

Key Responsibilities:

• Communicate and collaborate with PCM/CSR to request payment and payment status
• Follow up on unpaid medical insurance claims within standard billing cycle timeframe.
• Review and appeal denied or unpaid medical claims.
• Generate and review statements for legal services related to healthcare billing
• Call patient for all non-responsive Attorneys
• Schedule follow-up reminders while working assigned Attorneys
• Document actions in practice management system
• Collaborate with medical billing and coding staff to resolve discrepancies and ensure accurate billing records
• Prepare reports and analysis of accounts receivable status for management review
• Answer all Attorney/patient inquiries pertaining to assigned accounts
• Carry out collection and reporting activities according to specific deadlines
• Collaborate with pods and Director to discuss account statuses/challenges and collection strategies on a periodic basis
• Maintain confidentiality of patient and legal information in accordance with HIPAA regulations and ethical standards.

Job Requirements:

• Proven experience as a Medical Accounts Receivable Specialist or Legal Accounts Receivable Specialist, preferably in a healthcare setting.
• Familiarity with medical and legal billing software (e.g., Nextgen) and proficiency in Modern IT software (eg, Microsoft Office Suite, Excel, PowerPoint, Salesforce, Word ETC.)
• Strong understanding of medical billing processes, including CPT and ICD-10 coding, and legal billing practices
• Exceptional communication and interpersonal skills, with the ability to interact professionally with healthcare providers, legal professionals, and patients.
• Excellent attention to detail and ability to maintain accuracy in billing records.
• Customer service skills for interacting with Attorneys and patients regarding payments.
• Ability to work well in a team environment. Being able to triage priorities and multi-task.
• Strong organizational and time-management skills with the ability to prioritize tasks effectively.
• Problem-solving skills to research and resolve discrepancies and collections.
• A calm manner and patience working with patients and Attorneys during the process.
• Knowledge of legal terminology and procedures related to healthcare billing preferred
• Ability to understand the collection process - when to call Attorneys, when to follow-up, how to confirm balances have been paid, how to obtain proof of payment from the Attorney
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA (Health Insurance Portability and Accountability).

Preferred Qualifications:

• A minimum of two (2) years’ experience in health care billing/accounts receivable environment or related field, or any combination of education, training, or experience in a health care business office environment.