Patient Account Representative

Omega Healthcare Management Services; Boca Raton (FL); On-site; USD 35,000 - 50,000; Full time

Job summary

Omega Healthcare Management Services in Boca Raton is seeking a Patient Account Representative to manage communication with patients regarding medical billing and insurance claims.

Responsibilities include addressing inquiries, educating patients on financial assistance, and ensuring timely payment collection. The ideal candidate will have experience in medical billing and excellent communication skills.

This full-time position operates in a fast-paced environment and may require flexible hours.

Qualifications

• 1-2 years of experience in medical billing and insurance terminology.
• Proficient in computer skills and electronic health records.
• Experience in a customer service or call center role.

Responsibilities

• Handle patient billing inquiries via inbound and outbound calls.
• Educate patients about financial assistance programs and payment plans.
• Document patient communications accurately in databases.

Skills

Medical billing processes

Customer service

Problem-solving skills

Communication skills

Attention to detail

Education

High School diploma or equivalent

Additional education in healthcare administration

Tools

Microsoft Office

EHR or billing software

Job description

Summary and Objective

Under supervision, the Patient Account Representative will be responsible for effectively communicating with patients to explain medical billing and insurance claims, resolve inquiries, and ensure timely payment collection.

Essential Job Functions

• Handle inbound and outbound patient calls to address medical billing statements, insurance claims, payment collection, and related financial matters.
• Provide outstanding customer service by addressing patient inquiries, resolving billing discrepancies, and answering questions regarding insurance benefits and claim status.
• Verify patient demographic and insurance information, ensuring accuracy and making necessary updates as required.
• Update patient accounts with relevant information obtained during phone conversations, including payment arrangements, financial assistance applications, or any other relevant documentation.
• Work closely with insurance companies, coding specialists, and other team members to resolve any claim denials or issues impacting patient payments.
• Assist patients in understanding and navigating the process for filing insurance claims and submitting necessary documentation.
• Educate patients on financial assistance programs, payment plans, and available resources for managing medical expenses.
• Document all communication with patients accurately and thoroughly in the appropriate systems or databases.
• Attend various meetings virtually such as team meetings, training meetings, one‑on‑one meetings, etc.
• Adhere to company policies, procedures, and regulatory guidelines to ensure compliance with patient privacy (HIPAA) and collection practices.
• Ability to prioritize and multi‑task in a fast‑paced, changing environment.
• Demonstrate ability to work in all work types and specialties.
• Demonstrate ability to self‑motivate, set goals, and meet deadlines.
• Demonstrate problem‑solving skills and the ability to think critically to identify and implement appropriate solutions.
• Demonstrate excellent verbal communication skills, with the ability to effectively explain complex billing and insurance concepts to patients.
• Strong active listening skills to understand patient concerns and provide appropriate resolutions.
• Maintain courteous and professional working relationships with employees at all levels of the organization.
• Work in accordance with corporate and organizational security policies and procedures, understand personal role in safeguarding corporate and client assets, and take appropriate action to prevent and report any compromises of security within the scope of position.
• Ability to remain calm and composed in stressful situations, and effectively de‑escalate any conflicts or disputes.
• Compassionate and empathetic personality to handle patient inquiries and concerns with sensitivity and professionalism.
• Skill in operating a personal computer and utilizing a variety of software applications is essential.
• Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation is an added advantage.

Position Type and Hours of Work

This is a full‑time position. Each employee’s schedule must be between the hours of 6:00 AM PST to 9 PM PST, Monday through Friday with the specific schedule for each employee to be agreed upon by the employee’s manager and the employee, taking into account the needs of the client. This position occasionally requires long hours and weekend work.

Travel

None

Required Education and Experience

• Minimum of 1–2 years prior experience/knowledge of medical billing processes, insurance terminology, and reimbursement practices.
• Proficient computer skills and experience with electronic health records (HER) or billing software systems.
• High School diploma or equivalent; additional education in healthcare administration or related field is a plus.
• Proven experience in a customer service or call center role, preferably within the healthcare industry.

Security Access Requirements

• Microsoft Office
• ADP
• Oracle
• E1 – Field Employee
• Standard Employee
• Standard

Additional Qualifications

• Minimum 2–3 years of experience in a customer service call center environment.
• Ability to use de‑escalation practices for escalated disputes.
• Ability to understand and apply guidelines, policies and procedures.
• Must possess the ability to read, write and communicate in English.
• Ability to communicate effectively both verbally and in writing.
• Data entry skill level – minimum of 40–50 WPM, preferred higher.
• Medical billing experience (preferred).
• Bi‑lingual (preferred).
• Prior experience in a third‑party collection or medical collections and knowledge of industry terminology, principles and procedures.
• Basic computer skills.
• Motivation, teamwork, customer/patient focus, professionalism, organizational skills.
• Requires knowledge of state and federal healthcare laws and regulations.
• Strong attention to detail and accuracy.
• Ability to learn and master multiple computer and phone systems quickly.
• Highly developed communication skills to effectively work with all levels of management throughout the organization.
• Knowledge of DRG's, Revenue Codes, CPT/HCPC Codes, modifier assignment and government rules/regulations for inpatient and outpatient hospital billing, skilled nursing billing, inpatient rehab and inpatient psych.
• Experience with Epic, denials/appeals and/or account resolution.

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, or genetic information. Omega Healthcare also prohibits harassment of applicants or employees based on these protected categories.