Patient Account Representative

Pyramid Consulting, Inc; Pomona (CA); On-site; USD 29,000 - 33,000; Full time

Job summary

Pyramid Consulting, Inc. has an immediate opening for a Patient Account Representative in Pomona, CA. This is a 13-month contract onsite with benefits. You will review AR aging, follow up on hospital claims, and manage UB-04 facility claims to maximize reimbursements.

Requirements include 1–3 years in hospital accounts receivable or healthcare collections, with experience in inpatient and outpatient collections and payer guidelines. Strong communication and detail-oriented work are essential.

Qualifications

• 1–3 years in hospital accounts receivable, medical collections, or healthcare collections
• Experience with UB-04 (Institutional/Facility) claims
• Experience with inpatient and outpatient collections
• Familiarity with CPT, ICD, DRG reimbursement
• Knowledge of Medicare/Medicaid/MCH payer guidelines
• Strong communication and negotiation skills with payers
• Proficiency with hospital billing/follow-up systems and MS Office
• Detail-oriented with solid organizational skills

Responsibilities

• Review AR aging reports and prioritize collections.
• Follow up with insurance carriers on outstanding hospital claims.
• Perform collections for institutional facility claims.
• Investigate denials and appeals to maximize reimbursement.
• Coordinate with billing and other departments to resolve discrepancies.
• Document all collection activities in the billing system.

Skills

Hospital AR

Healthcare collections

UB-04 claims

Inpatient & Outpatient

Insurance follow-up

Communication skills

MS Office

Analytical thinking

Attention to detail

Education

High School Diploma or GED

Tools

Microsoft Office

Hospital billing system

Job description

Immediate need for a talented Patient Account Representative. This is a 13 months contract opportunity with long-term potential and is located in Pomona, CA (Onsite). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-23454

Pay Range: $21 - $24/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Review accounts receivable aging reports and prioritize collection activities
• Follow up with insurance carriers regarding outstanding hospital claims
• Perform collections and follow-up for institutional (UB-04) facility claims
• Investigate, correct, and appeal denied or underpaid claims to maximize reimbursement
• Coordinate with billing and other internal departments to resolve claim discrepancies
• Accurately document all collection and follow-up activities in the billing system
• Verify patient insurance eligibility through payer websites, insurance portals, and customer service representatives
• Maintain compliance with HIPAA, organizational policies, and applicable state and federal regulations.

Key Requirements and Technology Experience:

• Key Skills; Experience with Hospital Accounts Receivable (AR)
• Experience with Healthcare/Medical Collections
• Experience with UB-04 (Institutional/Facility) Claims
• Experience with Inpatient & Outpatient Collections
• Experience with Insurance Follow-Up / Facility Claims
• 1-3 years of experience in hospital accounts receivable, medical collections, or healthcare collections
• Required experience with both inpatient and outpatient collections
• Experience handling UB-04 (Institutional/Facility) claims
• Experience collecting facility claims across multiple lines of business
• Working knowledge of hospital billing processes, CPT, ICD, and DRG reimbursement methodologies
• Familiarity with Medicare, Medicaid/Medi-Cal, and commercial insurance payer guidelines
• Strong communication and negotiation skills for interacting with insurance payers
• Proficiency with hospital billing/follow-up systems and Microsoft Office
• Excellent analytical skills with the ability to identify claim denials, payment variances, and reimbursement opportunities
• Strong attention to detail and organizational skills
• High School Diploma or GED required

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.