Patient Account Rep III

Piedmont Healthcare Inc.; Oregon; Ibrido; USD 65.000 - 90.000; Tempo pieno

Descrizione del lavoro

Piedmont Healthcare Corporate is seeking an experienced senior specialist to resolve the most complex claim issues, denials and payer escalations. This role requires advanced knowledge of payer rules, regulatory requirements, and audit-ready documentation.

The Senior Specialist will act as a subject matter expert, support training and quality initiatives, and collaborate with leadership to improve processes and payer performance.

Competenze

• H.S. Diploma or GED required.
• 3 years of hospital billing/denial management experience.
• Experience with complex payer types; Medicare Advantage, Medicaid Managed Care, Workers' Compensation, TPL, MSP preferred.

Mansioni

• Resolve the most complex claim issues, denials, and payer escalations.
• Act as subject matter expert; support training and quality initiatives.
• Partner with leadership to improve processes and payer performance.

Conoscenze

Hospital billing

Denial management

Payer rules

Formazione

GED

Strumenti

Epic

Descrizione del lavoro

Responsibilities

This position serves as a senior specialist responsible for resolving the most complex claim issues, denials, and payer escalations. This role requires advanced knowledge of payer rules, regulatory requirements, and audit ready documentation. Representative III acts as a subject matter expert, supports training and quality initiatives, and partners with leadership to improve processes and payer performance.

Qualifications

Education

• H.S. Diploma or General Education Degree (GED) Required

Work Experience

• 3 years of progressively responsible experience in hospital billing, follow up, denial management, or related revenue cycle functions. Required
• Experience with complex payer types (Medicare Advantage, Medicaid Managed Care, Workers' Compensation, TPL, MSP). Preferred
• Advanced Epic proficiency. Preferred
• Experience supporting training, quality review, or process improvement. Preferred

Business Unit : Company Name Piedmont Healthcare Corporate