Patient Account & Billing Specialist (Collections)

Med-Metrix; Arlington (VA); On-site; USD 52,000 - 68,000; Full time

Job summary

Med-Metrix seeks a Patient Account Representative to handle collections, account follow-up, and billing allowances for assigned accounts. You will work with payers to resolve claims promptly, verify payer responsibility, and maintain accurate patient information.

Proficiency in Microsoft Office and experience with hospital billing is required. You will use systems like STAR, SMS, EAGLE and EPIC to collect payments and monitor denials, while maintaining HIPAA compliance and professional

Qualifications

• High School Diploma or equivalent required.
• Medical Billing and Coding certification preferred, but not required.
• Experience in Hospital/Facility billing required.
• 2-3 years' experience in insurance collections, including submitting and following up on claims.
• Basic knowledge of healthcare claims processing including ICD-9/10, CPT and HCPC codes, UB-04.
• Ability to use workflow systems and client host systems to collect payments and resolve accounts.
• Understanding of insurance follow-up processes and healthcare reimbursement methodologies.

Responsibilities

• Follow-up with payers to ensure timely resolution of outstanding claims via phone, emails, fax or websites.
• Review and update patient and financial information accurately as given.
• Verify payer responsibility for payment of bill.
• Monitor all billings for accuracy and update errors.
• Monitor Medicaid/healthy options coupons to ensure timely billing.
• Bill all hospital services to primary insurer or patient correctly and within expected timeframe.
• Follow up with insurance companies on all assigned accounts within expected timeframe.
• Explain hospital regulations regarding payment methods and HIPAA/compliance.
• Identify and report underpayments and denial trends.
• Analyze and resolve payer payment delays; initiate appeals when necessary.
• Manipulate Excel spreadsheets and communicate results.
• Meet daily productivity and quality standards.
• Maintain confidentiality at all times.
• Use PHI in accordance with HIPAA; follow Information Security policies.
• Limit viewing of PHI to necessary amounts.

Skills

Interpersonal skills

Communication skills

Microsoft Office

Attention to detail

Typing

HIPAA awareness

Education

High School Diploma or equivalent

Medical Billing & Coding certification (preferred)

Tools

STAR

SMS

EAGLE

EPIC

Job description

Med-Metrix seeks a Patient Account Representative to handle collections, account follow-up, and billing allowances for assigned accounts. You will work with payers to resolve claims promptly, verify payer responsibility, and maintain accurate patient information.

Proficiency in Microsoft Office and experience with hospital billing is required. You will use systems like STAR, SMS, EAGLE and EPIC to collect payments and monitor denials, while maintaining HIPAA compliance and professional