Account Representative

Prime Healthcare; Harlingen (TX); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Paid vacation

Sick time

Holidays

401K

Tuition reimbursement

Life insurance

Disability insurance

Job summary

Prime Healthcare seeks an Account Representative to join the Harlingen Central Billing Office in Harlingen, TX. The role focuses on posting and reconciling daily payments, applying adjustments, and ensuring accurate patient account reimbursement.

The position involves analyzing insurance payments for compliance with contracts and regulations, resolving underpayments or denials, and coordinating with payers and internal teams while maintaining professional patient communications.

Qualifications

• Ability to multi-task and prioritize to meet timelines.
• Analytical and problem-solving skills preferred.
• Customer service experience preferred.
• Effective written and verbal communication skills.
• Experience in accounts payable/receivable or cashier roles preferred.
• Familiarity with medical billing requirements and insurance terminology preferred.
• High School Diploma or GED required.
• Knowledge of medical coding and third-party operating procedures helpful.
• Know multiple insurance billing requirements; 6 months to 1 year billing experience preferred.
• Medical and insurance terminology essential.

Responsibilities

• Post and reconcile daily payments and apply contractual adjustments.
• Analyze insurance payments and managed care contracts for accurate reimbursement and compliance.
• Identify and escalate underpayments or denials with payers and internal teams.
• Distribute billing and manage hospital mail; correct mailing discrepancies.
• Communicate effectively with patients and internal stakeholders regarding accounts.

Skills

Multi-tasking

Analytical skills

Customer service

Communication skills

Billing knowledge

Medical terminology

Education

High School Diploma or GED

Tools

Billing software

Job description

Overview

Shifts Available: Days

Employment Type: Full-time

Hours: 8-hour shifts

Location: Harlingen Central Billing Office – Harlingen, TX

We are seeking an Account Representative, sometimes referred to as a Patient Financial Services Representative, or Patient Account Services Representative. The Account Representative is responsible for accurately posting and reconciling daily payments, applying contractual adjustments, and ensuring patient accounts reflect correct and timely reimbursement. The Account Representative analyzes insurance payments for compliance with managed care contracts and state and federal regulations, resolves underpayments or denials, distributes billing and correspondence appropriately, and provides professional support to patients and internal departments.

Responsibilities

• Accurately post and reconcile daily incoming payments, apply contractual adjustments, and maintain correct patient account balances within hospital systems
• Analyze insurance payments and managed care contracts to ensure accurate reimbursement and compliance with state and federal regulations, including Worker’s Compensation fee schedules
• Identify, investigate, and escalate underpayments or denials while collaborating with payers and internal departments to optimize revenue collection
• Distribute billing appropriately, manage hospital-related incoming and outgoing mail, and promptly correct mailing discrepancies
• Provide professional, tactful communication when assisting patients, families, and internal stakeholders regarding account inquiries and payment matters

Qualifications

• Ability to multi-task, prioritize needs to meet required timelines
• Analytical, mathematical and problem-solving skill preferred
• Customer Services experience preferred
• Effective written and verbal communication skills
• Experience in accounts payable, accounts receivable or cashier experience preferred
• Familiar with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred
• High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)
• Knowledge of basic understanding medical coding and third-party operating procedures and practices
• Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience preferred
• Medical and Insurance terminology essential

Benefits

• Health, dental, and vision insurance options
• Paid vacation, sick time and holidays
• Bereavement leave, FMLA and other leave options
• Employer 401K options
• Tuition reimbursement options
• Life, disability, and other insurance options
• Many other amazing benefits

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf