Patient Account Representative

St. Joseph's/Candler; Savannah (GA); On-site; USD 42,000 - 60,000; Full time

Job summary

St. Joseph's/Candler is seeking a Patient Accounts Representative in Savannah, GA to manage claims submission and follow-up. You will review edits from Meditech and Cirius, ensure compliance with federal/state regulations, and drive timely resolution of denials and adjudication.

The role involves busy daily billing, prompt follow-up, and maintaining accurate records. Ideal candidates have 2–3 years of medical accounts or hospital experience and strong customer service skills, with a High School

Qualifications

• 2-3 years medical accounts or hospital experience.
• 2-3 years customer service experience.
• High School Diploma preferred.

Responsibilities

• Resolves payer denials promptly and follows up on claims.
• Mails paper claims and re-bills as needed.
• Reviews reminders, documents actions, and follows up.
• Submits claims through Meditech and clearinghouse with confirmations.
• Reviews Accounts Receivable aging and contacts payors for status.
• Ensures pre-authorization and treatment authorizations as required.

Skills

Customer service

Billing

Attention to detail

Education

High School Diploma - Preferred

Tools

Meditech

Billing Clearinghouse

Job description

The Patient Accounts Representative is responsible to prepare and submits claims to various insurance companies either electronically or by paper. They will need to ensure that all insurance claim edits from Meditech and Cirius are reviewed, analyzed and resolved. Ensure that the claims are compliant with federal and state regulations. Patient Account Representative is responsible for ensuring that all insurance claims are processed and paid. They will perform all follow up activity on the claim until adjudication. Responsibilities include but are not limited to billing, prompt follow-up and understands the laws that govern the billing.

Education

• High School Diploma - Preferred

Experience

• 2-3 Years Medical Accounts or Hospital experience - Preferred
• 2-3 Years Customer Service experience - Preferred

License & Certification

• None Required

Core Job Functions

• Resolves payer denials promptly and appropriately. Mails paper claims promptly to the proper address. Re-bills accounts when necessary.
• Acts upon computer reminders promptly and appropriately. Uses the most effective follow up method needed. Documents all action taken.
• Files claims as assigned. Follows up on secondary aged accounts according to established time parameters. Resolves reminders promptly.
• Submits assigned claims through Meditech and Billing Clearinghouse and provides confirmation reports to the manager. Reviews the Accounts Receivable Aging Report and works outstanding claims, oldest to newest, making calls to appropriate payor to determine claim status. Works with payor on resolving claim disputes, submits requested paperwork, and notifies Appeals Group for all denials.
• Daily performs billing functions to include but not limited to review and verification of electronic claims, transmission of claims to clearing house, preparation of paper claims as needed, preparation of secondary claims, processing of overpayment and underpayment responses and payment posting as assigned. Review treatment authorization status and obtain pre-authorization as needed. Coordinate and review upcoming appointments with operations assistant to assure pre-authorizations for provider visits.
• Seeks answers/assistance from the appropriate source. Keeps up to date on billing/compliance rule changes.