PATIENT ACCOUNT REP I

LE0010 Stanford Health Care; Palo Alto (CA); On-site; USD 45,000 - 50,000; Full time

Job summary

Stanford Health Care is seeking a Patient Account Representative (PAR) I to process insurance balance claims and support the business office in resolving unpaid or denied patient accounts. Under close supervision, you will perform clearly-defined, routine duties.

Responsibilities include payer follow-up, documentation requests, Epic workflow, and basic claims follow-up with attention to accuracy. A High School diploma or GED is required, plus one year of related experience.

Qualifications

• High School diploma or GED
• One year of directly-related work experience
• Meets weekly productivity goals and standards
• Communicates professionally with PFS staff, payers, and patients
• Follows oral and written instructions and internal policies
• Maintains confidentiality of sensitive information
• Knowledge of payer landscape incl. Medicare/Medicaid/Workers’ Compensation/Managed Care/Commercial insurance

Responsibilities

• Respond to payer requests (records or documentation) by mail or payer portals
• Field incoming correspondence for the business office
• Work in Epic; resolve work queues and locate documentation
• Perform printing and mailing functions; edit and submit claims to payers
• Handle basic claims follow-up, denials, underpayments, or rejections

Skills

Accounts receivable collections

Payer follow-up

Payment posting

Medical billing operations

Professional communication

Education

High School diploma or GED

Tools

Epic

Job description

Patient Account Representative (PAR)

The Patient Account Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. The PAR works in various capacities to support the primary goal of the business office to resolve unpaid, underpaid, denied or unresolved patient accounts. Depending on the specific team, the PAR's focus may be on a mix of various responsibilities from across the Patient Financial Services (PFS) operations.

Responsibilities may include:

• Accounts receivable collections and payer follow-up
• Payer basic clerical denial review and request processing
• Payment posting and batch reconciliation
• Credit balance review and resolution
• Retroactive eligibility and registration
• Underpayment reconciliation
• Client or other special billing

The PAR I is an entry-level position. Under initial close supervision, a PAR I can perform clearly-defined and routine duties. A PAR I may be responsible for responding to straight-forward queries or issues, and is able to recognize when to refer or elevate issues to others.

Locations

Stanford Health Care

What you will do

• Responding to requests from the payer, such as providing medical records or other documentation either by mail or via payer portals
• Fielding incoming correspondence for the business office and distributing it appropriately
• Working in Epic; resolving work queues, finding Epic documentation, or performing other follow-up or business office-related activities
• Performing printing and mailing functions Electronic or hardcopy claims editing and submission to payers
• Basic claims follow up, denials, underpayments, or payer rejections

Education Qualifications

• High School diploma or GED equivalent

Experience Qualifications

• One (1) year of directly-related work experience.

Required Knowledge, Skills and Abilities

• Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager
• Can maintain professional communication with various PFS staff, payers, and patients regarding the billing of services
• Ability to follow oral and written instructions and interpret institutional and other policies accurately
• Ability to communicate clearly and professionally both verbally and in writing
• Ability to maintain confidentiality of sensitive information
• Ability to perform basic mathematics
• Ability to plan, prioritize, and meet deadlines
• Ability to work effectively with individuals at all levels of the organization
• Knowledge of accounts receivable software systems and medical billing operations
• Familiarity with medical reimbursement policies and procedures and medical terminology
• Knowledge of payer landscape, including Medicare, Medicaid, Workers’ Compensation, Managed Care, or other Commercial insurance

Licenses and Certifications

None

These principles apply to ALL employees: SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C‑I‑CARE standards for all of patients, families and towards each other. C‑I‑CARE is the foundation of Stanford’s patient‑experience and represents a framework for patient‑centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery. You will do this by executing against our three experience pillars, from the patient and family’s perspective:

• Know Me: Anticipate my needs and status to deliver effective care
• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
• Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer

Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non‑discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale

Generally starting at $32.42 - $36.48 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage. At Stanford Health Care, we seek to provide patients with the very best in diagnosis and treatment, with outstanding quality, compassion and coordination. With an unmatched track record of scientific discovery, technological innovation and translational medicine, Stanford Medicine physicians are pioneering leading edge therapies today that will change the way health care is delivered tomorrow. As part of our spirit of discovery, we also leverage our deep relationships with luminary Silicon Valley companies to develop new ways to deliver preeminent patient care. Learn about our awards and significant events.