Job Details

The Patient Collections Representative is responsible for the collection of patient balances for both self-pay accounts and patient responsibility balances following insurance adjudication. This role requires direct interaction with patients through phone, email, and in-person communication.

The representative is responsible for generating, reviewing, and mailing patient statements for assigned facilities within corporate-established timeframes. The role requires the ability to explain the medical billing and insurance reimbursement process clearly and professionally while addressing patient questions, complaints, and concerns to resolution.

• Minimum Education:
  High School Diploma or G.E.D. required.
  
  Required Knowledge & Skills:
• Demonstrated understanding of the insurance revenue reimbursement cycle, including payer adjudication, patient responsibility, and post-adjudication collections.
• Proven ability to read, analyze, and interpret Explanation of Benefits (EOBs) to determine payment accuracy, denials, adjustments, and patient balances.
• Working knowledge of the medical revenue cycle, including patient registration, charge capture, billing, insurance reimbursement, and patient collections.
• Familiarity with managing patient accounts and collections while ensuring compliance with billing policies, payer guidelines, and applicable regulations.
• Strong computer and keyboarding skills, with the ability to type a minimum of 40 WPM.
• Ability to navigate multiple computer systems and software applications while actively communicating by phone.
• Proficiency with Windows-based PC applications and the ability to quickly learn new systems and workflows.
• Experience with practice management or billing systems; experience with Centricity is beneficial.
• Communication & Professional Skills:
• Strong verbal and written communication skills with the ability to explain complex billing and insurance information in clear, simple terms.
• Demonstrated problem-solving and negotiation skills related to patient balances and reimbursement discrepancies.
• Ability to multitask, prioritize responsibilities, and work both independently and collaboratively in a fast-paced environment.
• Positive attitude, strong work ethic, and team-oriented mindset.
• Willingness to train the proper candidate who demonstrates foundational revenue cycle knowledge.
• Bilingual/Spanish-speaking ability is a plus.
• Experience:
• Minimum of 2 years of experience in customer service, collections, medical billing, or a healthcare revenue cycle-related role preferred.
• Prior experience working with self-pay and commercial insurance accounts strongly preferred.

Job Responsibilities / Duties

• Answer incoming patient calls and accurately identify the type of assistance needed, including benefits and eligibility, billing and payments, authorizations, and Explanation of Benefits (EOBs).
• Ask appropriate questions and actively listen to identify patient concerns while accurately documenting required information in computer systems.
• Resolve patient inquiries through to completion in real time, including timely and comprehensive follow-up when required.
• Communicate clearly and professionally with patients to ensure full understanding of their bills, statements, and insurance processing.
• Initiate collection efforts on all open patient balances via statements, phone calls, and email correspondence, including negotiation when appropriate.
• Address patient concerns related to care, costs, and overall billing experience with professionalism and empathy.
• Set up, process, and monitor patient payment plans as necessary.
• Respond promptly and accurately to written correspondence from patients.
• Generate, review, and mail patient statements within corporate-assigned timeframes.
• Maintain complete, accurate documentation of all collection activities in compliance with HIPAA and company policies.
• Stay informed of changes to payer rules, billing guidelines, procedures, and applicable federal and state regulations.
• Meet established performance goals related to efficiency, accuracy, quality, patient satisfaction, and attendance.
• Perform additional duties as assigned by department management.

Working Conditions

• Frequent speaking and listening using a headset.
• Continuous use of hands and fingers for keyboarding and mouse navigation.
• Extended periods of working at a computer.
• Moderate noise level due to conversations, computers, printers, and general floor activity.
• Frequent standing, walking, and sitting during the workday.
• Must submit to random drug screenings.

Full-Time Benefit Perks:

• Health benefits start on the first of the month after hire
• Medical, dental, and vision plans with sliding-scale premiums
• 100% coverage for preventive health services
• HSA and FSA options available
• Company-paid life insurance and long-term disability
• 401(k) with contributions starting after 30 days
  • 100% match on the first 4%,
  • Full vesting after 3 years
• Access to exclusive employee discounts on travel, fitness, shopping, and more
• Paid Time Off

Join us and make a significant impact on our company's success in reaching our target audience and driving business growth.