Patient Account Representative

Company Overview

At HME Home Medical, we believe in creating a positive and supportive work environment. Our core values—care, competency, respect, and joy—guide everything we do. We’re passionate about delivering exceptional service to our customers while fostering a culture of growth, collaboration, and happiness.

Job Overview
We are seeking a detail-oriented and knowledgeable Patient Accounts Representative to join our team. This role is essential in resolving outstanding unpaid, unprocessed and/or denied medical claims to third-party payers. This role frequently interfaces with our third-party billing agency as well as insurance companies and patients. The ideal candidate will possess a strong understanding of medical terminology and billing practices, along with the ability to navigate various medical systems efficiently.

Duties

• Answer patient phone calls, assist with payment processing and resolution of billing questions.
• Reviews, research, and resolves the accounts being worked.
• Verifies accuracy of billing data and corrects errors; prepares and resubmits clean claims to multiple contracted insurance companies and government payers.
• Performs workflows in a productive and effective manner as defined by policies and procedures.
• Provides appropriate and detailed documentation of research and outcomes on accounts.
• Accesses payor websites for claims status, eligibility of services and reconsiderations.
• Processes claims-related correspondence (i.e., denials, appeals, payer requests).
• Maintains work queues to ensure timely submission and follow-up of claims.
• Utilizes accounts receivable (AR) reports and explanation of benefits (EOBs) to identify and resolve outstanding third-party claims.
• Notifies management team of payer trends and issues that may affect workflow and management of claims.
• Willingly accepts other duties as assigned.

Experience

• High school diploma or equivalent (required).
• Associate’s degree in business, medical records technology or related field (preferred).

Education

• 2 years of experience processing medical insurance claims (required) .

Knowledge and Skills

• Maintain the privacy and confidentiality of all staff and clients in line with HIPAA standards.
• Demonstrates a high level of accuracy.
• Friendly and service oriented; articulate and responsive to customers.
• Demonstrated time management and priority setting skills; performs work independently with minimal supervision.
• Ability to learn and use various financial applications and payer websites to check claim status, eligibility, and authorization status.
• Knowledge of payer reimbursement methodologies and ability to understand insurance correspondence and resolve variances.
• Ability to understand the UB04 and HCFA 1500 claim forms and coding requirements for each form.
• Must maintain professionalism, including professional phone etiquette.

Job Type: Full-time

Pay: $20.00 - $25.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

People with a criminal record are encouraged to apply

Experience:

• UB04 and HCFA 1500 claim forms and coding: 1 year (Preferred)
• Medical Billing: 2 years (Required)

Ability to Commute:

• Green Bay, WI 54301 (Required)

Work Location: In person

Salary : $20 - $25