Patient Account Representative

Prestige Staffing; Knoxville (TN); On-site; USD 40,000 - 55,000; Full time

Job summary

A healthcare staffing agency is seeking a Patient Account Representative based in Knoxville, Tennessee. This role supports the hospital's revenue cycle by performing duties such as medical billing, insurance follow-up, payment postings, and providing customer service. Candidates should have experience in billing services and strong communication skills. The position emphasizes customer care and accuracy in patient account management, making it crucial for ensuring timely reimbursements from insurance carriers and patients.

Qualifications

• Experience in hospital or physician practice billing, insurance follow-up, payment posting, or patient account services.
• Knowledge of medical terminology, billing regulations, and insurance processes.
• Ability to work efficiently with electronic health records, billing software, and payer portals.

Responsibilities

• Review and maintain patient account information for accuracy.
• Prepare electronic or paper claims for submission to payers.
• Monitor outstanding accounts and follow up on unpaid, denied, or delayed claims.
• Respond to patient inquiries regarding account balances and payment options.

Skills

Communication skills

Problem-solving

Customer service

Tools

Billing software

Electronic health records (EHR)

Job description

The Patient Account Representative is responsible for supporting the hospital’s revenue cycle by performing a range of patient accounting functions, which may include medical billing, insurance follow-up, payment posting, and customer service. This role ensures the accurate processing of patient accounts and timely reimbursement from insurance carriers and patients while delivering excellent service to both internal and external stakeholders.

Key Responsibilities

Patient Account Management

• Review and maintain patient account information to ensure accuracy of demographics, insurance coverage, and financial data.
• Communicate with patients, families, and clinical staff to obtain missing information or clarify account details.

Medical Billing & Claim Preparation

• Review encounter documentation, charge information, and supporting records to prepare accurate claims.
• Apply appropriate coding standards (e.g., ICD-10, CPT, HCPCS) when required to ensure compliance with payer and regulatory guidelines.
• Verify insurance eligibility, benefits, and authorization requirements prior to claim submission.

Claim Submission

• Prepare electronic or paper claims for submission to commercial payers, government programs, and other third-party entities.
• Ensure all required information, attachments, and documentation are included to support proper claim adjudication.
• Process claims using designated billing software and hospital information systems.

Insurance Follow-Up & Resolution

• Monitor outstanding accounts and follow up promptly on unpaid, denied, or delayed claims.
• Communicate with insurance carriers to determine claim status, resolve discrepancies, and obtain clarification on denial reasons.
• Investigate and correct errors related to coding, billing, or eligibility to facilitate payment.
• Submit appeals or corrected claims as needed.

Payment Posting

• Accurately post insurance and patient payments, adjustments, and denials to the appropriate accounts.
• Reconcile daily payment reports and identify posting inconsistencies or missing items.
• Notify appropriate teams of trends or issues affecting reimbursement.

Customer Service

• Respond to patient inquiries regarding account balances, insurance billing, payment options, and financial assistance programs.
• Provide clear explanations of statements, benefits, and account activity in a professional and compassionate manner.
• Assist patients with setting up payment plans or directing them to financial counseling resources.

Qualifications

• Experience in hospital or physician practice billing, insurance follow-up, payment posting, or patient account services.
• Knowledge of medical terminology, billing regulations, and insurance processes.
• Strong communication, problem-solving, and customer service skills.
• Ability to work efficiently with electronic health records (EHR), billing software, and payer portals.