Patient Account Representative

MemorialCare Health System; Laguna Hills (CA); On-site; USD 36,000 - 51,000; Full time

Job summary

MemorialCare Health System's Saddleback Memorial Medical Center in California is seeking a Patient Account Representative III to manage Medi-Cal, Medicare, Cal-optima and managed care payments, verify insurance, obtain authorizations, and coordinate financial aspects of admissions and visits.

The role emphasizes accuracy in reimbursement, speed in submitting claims, and accountability in accounts receivable, with opportunities for bonuses and shift differentials.

Qualifications

• Previous hospital experience including knowledge of commercial, government and managed care insurance.
• Knowledge of Billing and follow-up procedures.
• Experience in Typing.
• Use of 10-key calculator.
• Knowledge of Microsoft Office Suite.

Responsibilities

• Submit Medicare, Commercial, and private pay claims in a timely fashion.
• Review and calculate Medi-Cal, Medicare, Cal-optima and managed care payments for accurate reimbursement.
• Research and follow up on insurance refunds to ensure accurate account balances.
• Monitor and update all invoices from different vendors and document communications in the Hospice/Health system.
• Complete end-of-month closing and generate statistical reports.
• Monitor and analyze Accounts Receivable to minimize days in A/R.
• Verify insurance coverage for all payer types for patient admissions and obtain authorizations.
• Be punctual and follow company policies and directives.
• Interact positively and multi-task effectively.

Skills

Typing

10-key calculator

Billing

Microsoft Office Suite

Education

High School diploma or equivalent

Tools

Microsoft Office Suite

10-key calculator

Job description

Job Description - Patient Account Representative (SAD007769)

Job Description

Description

Department: Radiology TherapRadiology Therapeuticeutic

Status: Full-time

Shift: Days (8hr shifts)

Pay Range: $25.71/hr - $37.28/hr

At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in healthcare.Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability.Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

This position requires the full understanding and active participation in fulfilling the mission of Saddleback Medical Center. It is expected that the employee demonstrate behavior consistent with our core values: Integrity, Accountability, Best Practices, Compassion and Synergy. The employee shall support Saddleback Medical Center’s strategic plan and participate in and advocate performance improvement/patient safety activities.

The Patient Account Rep III position requires knowledge of all Medi-Cal, Cal-optima, Medicare & Managed care contracts to review all payments received. This position is also required to identify research and prepare insurance refunds to ensure accurate reimbursements. The Patient Account Rep III works under the direction of the Hospice A/R Manager to coordinate all financial aspects of patient admissions, and visits to include Benefits, insurance verification, pre- certification information, authorization and patient’s change of insurance process. To encompass all payer types. Assures Insurance information is accurate. Knowledge of insurance payor types

Essential Functions and Responsibilities of the Job

• Ability to submit Medicare, Commercial, and private pay claims in a timely fashion
• Demonstrates ability to precisely review and calculate all Medi-Cal, Medicare, Cal-optima and managed care payments to ensure accurate reimbursement
• Demonstrates ability to research and/or follow up on insurance refunds to ensure accurate account balances
• Monitors, Pays, Updates all Invoices from different vendors. Document appropriately in the Hospice/Health system all correspondences and other transactions in interacting with Accounts Payable and Vendors
• Ability to complete end-of the month closing and statistical reports
• Demonstrates ability to monitor and analyze Accounts Receivable (A/R) to ensure minimal number of days in A/R
• Ability to verify insurance coverage for all payer types for patient admissions. Makes written and or verbal inquires to third party payer to verify insurance benefits, eligibility and insurance status
• Obtains and tracks all authorizations for Palliative and hospice patients
• Ability to be at work and be on time
• Ability to follow company policies, procedures and directives
• Ability to interact in a positive and constructive manner
• Ability to prioritize and multitask

Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards

Qualifications

Experience

• Previous hospital experience including knowledge of commercial, government and managed care insurance
• Knowledge of Billing and follow-up procedures
• Experience in Typing
• Use of 10-key calculator
• Knowledge of Microsoft Office Suite

Education

• High School diploma or equivalent preferred

Job

Patient Financial,Claims,Bill

Organization

Saddleback Memorial Medical Center

Schedule

Full-time

Employee Status

Regular

Job Level

Staff

Job Posting

Sep 21, 2026, 8:08:35 PM

Shift

Day Job

Scheduled Shift Start Time : 8:30 AM - Scheduled Shift End Time : 5:00 PM