Billing Specialist - Patient Account Representative

Astrana Health Management; Las Vegas (NV); On-site; USD 26,174 - 30,307; Full time

Job summary

Astrana Health is seeking a Billing Specialist - Patient Account Representative to support revenue cycle operations at our Las Vegas location. You will manage patient accounts, resolve balances, coordinate insurance activity, and assist with legacy cleanups during system transitions.

The ideal candidate has strong patient financial services experience, attention to detail, and ability to communicate across departments while upholding HIPAA and compliance.

Qualifications

• At least 2 years of medical billing experience in a multi-specialty or primary care setting.
• Experience with Medicare Advantage, HMO, PPO, and/or value-based payment models strongly preferred.
• Familiarity with CPT, ICD-10, HCPCS, and modifier usage.
• Strong attention to detail, organizational skills, and teamwork.

Responsibilities

• Review and resolve outstanding patient and insurance accounts by researching discrepancies, resolving claim issues and denials, contacting patients regarding outstanding balances, answering billing questions, and establishing payment arrangements to facilitate timely account resolution.
• Maintain a strong understanding of payer policies, RAF/HCC coding relevance, and risk adjustment impacts on reimbursement.
• Review and resolve outstanding AR and insurance denials by analyzing claims, researching discrepancies, and submitting appeals as needed.
• Prepare, review, and submit clean medical claims for primary and secondary payers, including Medicare Advantage, Medicaid Managed Care, and commercial insurers as needed.
• Collaborate with internal departments and payers to identify root causes of denials and ensure timely resolution and reimbursement.
• Maintain patient confidentiality and demonstrate professionalism and empathy when discussing sensitive financial matters.
• Support audits, data clean-up initiatives, and quality reporting related to billing.
• Ensure compliance with HIPAA and all regulatory requirements.

Skills

Medical billing

Attention to detail

Organizational skills

Communication skills

Teamwork

Education

High school diploma or equivalent

Billing certification (CPB/CMRS/CBCS) preferred

Tools

eClinicalWorks

Athena

NextGen

Kareo

Job description

Billing Specialist - Patient Account Representative

Department: Billing - Central

Employment Type: Full Time

Location: 8880 W Sunset Rd, Suite 320, Las Vegas NV 89148

Reporting To: Lydia Allred

Compensation: $19.00 - $22.00 / hour

Description

About the Role

We are seeking a highly organized and detail-oriented Billing Specialist-Pt Account Rep to support accurate and efficient revenue cycle operations. This role plays a critical part in managing patient accounts by ensuring timely resolution of outstanding patient balances, supporting account reconciliation, coordinating insurance and patient payment activity, and assisting with legacy account cleanup during system transitions. The ideal candidate is customer-service driven, detail-oriented, and experienced in patient financial services, payment arrangements, insurance coordination, and account resolution while maintaining a strong commitment to accuracy, compliance, and continuous process improvement.

Our Values:

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What You'll Do

• Review and resolve outstanding patient and insurance accounts by researching discrepancies, resolving claim issues and denials, contacting patients regarding outstanding balances, answering billing questions, and establishing payment arrangements to facilitate timely account resolution.
• Maintain a strong understanding of payer policies, VBC metrics, RAF/HCC coding relevance, and risk adjustment impacts on reimbursement.
• Review and resolve outstanding accounts receivable (AR) and insurance denials by analyzing claims, researching discrepancies, and submitting appeals as needed.
• Prepare, review, and submit clean medical claims for primary and secondary payers, including Medicare Advantage, Medicaid Managed Care, and commercial insurers as needed.
• Collaborate with internal departments and payers to identify root causes of denials and ensure timely resolution and reimbursement.
• Maintain patient confidentiality and demonstrate professionalism and empathy when discussing sensitive financial matters.
• Support audits, data clean-up initiatives, and quality reporting related to billing.
• Ensure compliance with HIPAA and all regulatory requirements.

Qualifications

• High school diploma or equivalent required; associate degree or billing certification (e.g., CPB, CMRS, CBCS) preferred.
• At least 2 years of medical billing experience in a multi-specialty or primary care setting preferred.
• Experience with Medicare Advantage, HMO, PPO, and/or value-based payment models strongly preferred.
• Familiarity with EMR and billing software (e.g., eClinicalWorks, Athena, NextGen, Kareo).
• Working knowledge of CPT, ICD-10, HCPCS, and modifier usage.
• Strong attention to detail, organizational skills, and follow-through.
• Excellent communication and teamwork skills.

Environmental Job Requirements and Working Conditions

• Scheduling options: 7:30 AM – 4:00 PM or 8:00 AM – 4:30 PM with a 30‑minute lunch between 12:00–1:00 PM.
• The total compensation range for this role is $19–$22/hour. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and affirmative action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at [e-mail] to request an accommodation.

Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.