Patient Account Representative

Sheridan Memorial Hospital; Sheridan (WY); On-site; USD 42,000 - 60,000; Full time

Job summary

Sheridan Memorial Hospital is seeking a Billing Specialist to compile itemized hospital bills, verify patient insurance coverage, and compute insurance benefits. You will collaborate with Admitting Office, Medical Records, and insurers, and participate in Performance Improvement activities.

Work will involve ensuring timely claim submission, handling denials/edits in Cerner RevenueCycle, and maintaining accurate patient billing information.

Qualifications

• High school diploma or GED required.
• Medical terminology preferred.
• Previous office experience required.
• Billing or accounting preferred.

Responsibilities

• Verifies encounter information and corrects edits to ensure timely claim submission.
• Monitors claims and handles adjustments in Emdeon as needed.
• Contacts patients for additional information to file insurance claims.
• Keeps up-to-date with changes in major insurers and government programs.
• Processes explanations of benefits and overpayment refunds promptly.
• Maintains professionalism and confidentiality when interacting with patients and insurance providers.

Skills

Verbal & written communication

Office software

Ability to work under pressure

Multiline phone handling

Education

High School Diploma

Medical terminology, preferred

Tools

Cerner RevenueCycle

Emdeon

Job description

At Sheridan Memorial Hospital, we proudly rank in the top 13.6% of U.S. hospitals, recognized by the Centers for Medicare and Medicaid Services. With over 850 dedicated employees and 100+ expert providers across 25 specialties, we are committed to exceptional, patient-centered care. Set in northern Wyoming’s stunning Big Horn Mountain foothills, Sheridan offers outdoor adventure and community charm. Our hospital combines cutting-edge technology with a collaborative, innovative culture. Join a team that values your skills, fosters growth, and empowers you to impact lives meaningfully.

Nestled at the foothills of the Big Horn Mountains in northern Wyoming, spectacular scenery and outdoor activities abound. Our hospital has the latest technology and equipment comparative to that of many larger facilities, and you will find our staff friendly, compassionate, caring, and courteous. We focus on creating and nurturing a workplace that encourages, recognizes, and rewards individual effort and creativity. Leadership is responsive to changing modes of healthcare delivery and adapts accordingly. We value effective communication and honesty and believe teamwork based on mutual respect is key to success.

Job Summary

Responsible for compiling itemized hospital bills, verifying patient insurance coverage and computing patient insurance benefits. Works closely with the Admitting Office, Medical Records and insurance companies. Participates in Performance Improvement activities.

Essential Duties / Responsibilities

• Verifies accurate encounter information by working Edit Failure Working in Cerner, making necessary corrections to insure timely claim submission.
• Monitors all claims in Emdeon correcting edits as need to insure claim submission and reimbursement.
• Contacts patients when additional information is required to file an insurance claim or when the insurance company has requested additional information from the member
• Stays informed about changes in Medicare and Medicaid, Blue Cross/Blue Shield and other third party payors.
• Processes correspondence and Explanation of Benefits in a timely manner.
• Processes overpayment refunds as required.
• Timely in making contact with insurance companies on claims that have exceeded the time expectation for payment.
• Remains current on Worker’s Compensation and other third party payors for billing functions.
• Stays current on assigned patient encounter "workQ in Cerner RevenueCycle."
• Demonstrates the ability to be flexible, organized and function well in stressful situations.
• Interacts with patients/families in a professional manner. Provides explanations regarding statements, insurance coverage.
• Treats patients/families with respect; ensures confidentiality of patient records.
• Maintains a good working relationship within the department and with other departments.
• Maintains a professional working relationship with insurance companies.

Disclaimer: The above description has been designed to indicate the general nature of work performed within this position.

POSITION QUALIFICATIONS — Education/Experience/Licenses And Certifications

• High school diploma or general equivalency diploma (GED), required.
• Medical terminology, preferred.
• Previous office experience, required.
• Billing or accounting, preferred.

Additional Skills

• Ability to effectively communicate in English, both reading and writing.
• Multi-line telephone knowledge.
• Computer knowledge.
• Ability to operate designated equipment as specified, including computer keyboarding.
• Basic clerical training, including basic filing procedures (both numerically and alphabetically).
• Ability to work under pressure with time constraints.
• Basic knowledge of medical record content and sequence.
• Ability to function independently with minimal direction.

Specific demands not listed: Possible exposure to blood and or body fluids / infectious disease / hazardous waste requiring the use of Personal Protective Equipment. Exposure to odorous chemicals / specimens and Latex products. Pre-employment drug and alcohol screening is required.

Sheridan Memorial Hospital is an equal opportunity/Affirmative Action employer and gives consideration for employment to qualified applicants without regard to race, color, religion, age, sex, national origin, disability or protected veteran status.

If you would like more information about your EEO rights as an applicant under the law,

This position requires the employee to work onsite in Sheridan, Wyoming, USA. This position is not eligible for remote work or visa sponsorship.