Patient Account Representative III

US Lawns; Hilo (HI); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

13 paid holidays

21 paid vacation days

Medical, dental, vision plans

Employee Assistance Program

State retirement system

Student loan repayment programs

Job summary

Hilo Benioff Medical Center seeks a Patient Account Representative III to support patients and maximize reimbursement by resolving complex billing issues. You will ensure accurate claims processing and provide guidance to teammates, contributing to service quality.

The role requires 2+ years in medical billing and hospital collections, with strong communication and confidentiality, across a 24/7 hospital environment. Training and performance reviews are part of the duties.

Qualifications

• Experience in medical billing and hospital/long-term care collections.
• Typing, data entry, and customer service experience (2+ years).
• Substitution options: associate/bachelor’s degree may replace general experience.

Responsibilities

• Handle complex patient accounts and collections, review adjustments and credit balances.
• Process, review, and submit claims accurately while complying with payer rules.
• Resolve billing issues, including denials and payer concerns, as a customer contact.
• Assist training of new staff and audit lower-level reps for quality and compliance.
• Participate in process improvements and coordination with clinical departments.

Skills

Medical billing

Collections

Customer service

Payer communication

Attention to detail

Communication skills

Education

High school diploma or equivalent

Job description

Job Description

Join Hilo Benioff Medical Center and be part of a team that proudly cares for our friends, family, and neighbors across East Hawaiʻi.

Join Hilo Benioff Medical Center, a community hospital serving the people of Hawaiʻi Island and the surrounding communities. As a Patient Account Representative III, you will play an important role in supporting patients and the hospital by resolving complex billing and collection issues, ensuring accurate claims processing, and helping maximize reimbursement for services provided. You will also serve as a resource to team members through technical guidance, training, and quality-focused review of billing and collections work.

Key Responsibilities

• Manage complex patient account and collection activities, including reviewing adjustments and credit balances, resolving past-due accounts, arranging payment options, and assisting with financial inquiries.
• Process, review, correct, and submit claims accurately and timely while ensuring compliance with federal, state, and payer requirements and supporting maximum reimbursement.
• Resolve complex billing issues, including split billing, payer-related issues, regulatory denials, and other hospital billing concerns, while serving as a point of contact for patient financial services and customer service issues.
• Assist with training new employees, provide technical guidance to team members, and audit the work of lower-level Patient Account Representatives for accuracy, completeness, and compliance with established procedures.
• Participate in process improvement, quality audits, collections and customer service education, and coordination with clinical departments and other revenue cycle areas.
• Promote positive patient and customer relations through professional communication, teamwork, confidentiality, and responsive service to patients, visitors, physicians, staff, and insurance payers.
  

Required Qualifications

To qualify, you must meet all of the following requirements. Please note that unless specifically indicated, the required education and experience may not be gained concurrently. In addition, qualifying work experiences are credited based on a 40-hour workweek.

Education & Experience

Education

• High school diploma or equivalent.

Experience

• Two (2) years of general experience in typing, stenographic or clerical work, cashiering, data input, customer service, or a combination of these experiences.
• Two (2) years of specialized experience performing medical billing and collections in a hospital or long-term care facility, including interviewing patients or responsible parties regarding financial information, arranging payment or credit, determining financial status, reviewing delinquent accounts, and contacting payers for payment.

Substitution of Education for General Experience: An Associate’s or Bachelor’s from an accredited college or university may substitute for all of the General Experience required. Evidence of the appropriate training (e.g. official transcript or diploma) should be submitted with the application to be given credit for education. A legible photocopy will be accepted. However, HMC reserves the right to request an official copy.

Substitution of Specialized Experience: Work experience performing billing and collections in an organization (i.e., financial institution, retail, or hotel); interviewing persons to secure financial information, arranging for method of payment, extension of credit, reviewing accounts for delinquent payments and contacting payer to seek payment may substitute for one year of Specialized Experience.

Desired Skills & Knowledge

• Working knowledge of medical billing, collections, and follow-up in a hospital or long-term care setting.
• Knowledge of third-party insurance, including Medicare, HMSA, and Medicaid, and applicable medical billing rules and requirements.
• Knowledge of medical billing forms and coding systems, including UB-92/UB-04, HCFA 1500, ICD-9, CPT, HCPCS, DRG, and RUGS.
• Knowledge of credit and collection methods, the Fair Debt Collection Practices Act, interviewing techniques, office practices, and customer service principles.
• Ability to organize and evaluate information, communicate clearly, interact tactfully and objectively with others, follow applicable laws and policies, and maintain confidentiality.

Company Description

As the Big Island’s leading providers of inpatient and outpatient care, the East Hawaii Region of Hawai`i Health Systems Corporation (HHSC), consisting of Hilo Benioff Medical Center, Honoka'a Hospital, Ka′u Hospital, Yukio Okutsu State Veterans Home, East Hawaii Medical Group and East Hawaii Health Pharmacy, delivers a full range of services and programs. Our three hospitals include 290 beds and more than 1,900 employees. Our medical staff is comprised of 250 physicians, physician assistants and Advanced Practice Registered Nurses, representing 33 specialties. East Hawaii Health is our network of clinics offering primary and specialty care. Hilo Benioff Medical Center functions as a Level III Trauma Center, which includes the second busiest emergency room in the state, providing 24-hour care and serving more than 50,000 patients annually. Honoka'a Hospital and Ka′u Hospital are designated as Critical Access Hospitals. To learn more about the East Hawaii Region, please watch our Video Yearbook or visit www.hbmc.org, www.honokaahospital.org or www.kauhospital.org.

Benefits

• 13 paid holidays each year (104 hours); 14 (112 hours) during election years*
• 21 paid vacation days (168 hours) per year*
• 21 paid sick days (168 hours) per year*
• Medical, dental, vision, and prescription plans
• Employee Assistance Program
• Participation in the State of Hawaii’s retirement system
• Potential eligibility for various student loan repayment & scholarship programs

* Rates listed for paid holidays, vacation and sick days are for 1.0 Full Time Equivalent (FTE) positions assigned to 8 hour shifts. Accruals for these benefits are otherwise prorated based on FTE.

Pre-Employment Health Requirements

Offers of employment will be contingent on successfully passing a pre-employment examination, which includes a drug screen and other regulatory medical requirements such as, but not limited to, a tuberculosis (TB) screen. The cost for drug screening and blood draw for QuantiFERON and Titers, shall be borne by the Hawaii Health Systems Corporation.

Pre-Employment Assessments for External Candidates

As part of the recruiting process for this position, external applicants (job applicants NOTemployed byHHSC’s East Hawaii Region)are required to complete pre-employment assessments shortly after application submission. If you are notan employee of the East Hawaii Region of HHSC, youwill receive an email containing assessment instructions. We ask that you complete the assessments within two days of receipt of the request.

Equal Opportunity Employer

The East Hawaii Region of Hawaii Health Systems Corporation is a drug free workplace and an Equal Opportunity Employer.

Shift Details

Must be available to work shifts, weekends and holidays as necessary based on hospital operations. Services are provided 24/7.