Patient Account Representative III, Pro Fee

Jobtailor; Fairfield (CA); On-site; USD 60,000 - 90,000; Full time

Job summary

NorthBay Ambulatory Practices in Fairfield, CA seeks a Billing Specialist to manage timely, accurate billing and collections for ambulatory patient accounts. You will process accounts for diverse services across NorthBay, ensuring compliance with standard and NorthBay billing practices and regulatory requirements.

The role requires 3–5 years of professional fee billing experience, proficiency with CPT4/HCPCS/ICD-10, and solid knowledge of Medicare/Medicaid and commercial plans.

Qualifications

• Three to five years of recent professional fee billing and collections experience in a multi-specialty practice.
• Familiarity with CPT4, HCPCS and ICD-10 coding and regulatory requirements.
• Proficiency with Medicare, Medi-Cal and Commercial plans (HMO/PPO).
• Experience with UB-04 and HCFA 1500 billing and account follow-up resolutions.
• Knowledge of medical terminology and HIPAA-compliant work environment.

Responsibilities

• Timely and accurate billing, follow-up, and collection of ambulatory patient accounts.
• Process accounts for all services and specialties offered within the NorthBay Ambulatory practices.
• Use of standard and NorthBay prescribed billing practices and regulatory requirements.

Skills

Billing and collections

CPT4 coding

ICD-10 coding

Medical terminology

Problem solving

Adaptability

Education

High school diploma or equivalent

College courses in business preferred

Tools

UB-04 claim forms

HCFA 1500 claim forms

Job description

• Timely and accurate billing, follow-up, and collection of ambulatory patient accounts.


• Process accounts for all services and specialties offered within the NorthBay Ambulatory practices.


• Use of standard and NorthBay prescribed billing practices and regulatory requirements.

Requirements

• High school graduate or equivalent preferred. College courses with emphasis on Business preferred.


• Three to five years of recent professional fee billing and collections experience, preferably in a multi-specialty practice environment required.


• Familiarity with use of CPT4, HCPCS and ICD-10 coding.


• Proficiency in Medicare, Medi-Cal and Commercial insurance plans, both HMO and PPO.


• Experience with UB-04 and/or HCFA 1500 claim forms billing.


• Experience in account follow up resolution for both electronic and manual claims.


• Demonstrated ability to effectively investigate, analyze and problem solve.


• Knowledge of medical terminology.


• Ability to perform several different types of tasks each day and to adapt to changing priorities.


• Must have a private, distraction-free area in your home for work (HIPAA reasons).

Core Competencies

Demonstrates expertise in billing and collections for ambulatory patient accounts, with proficiency in CPT4, HCPCS, and ICD-10 coding. Capable of effectively managing claims processing and follow-up in compliance with Medicare, Medi-Cal, and commercial insurance regulations.

Highest-signal resume keywords

• Billing And Collections Experience


• CPT4 Coding


• ICD-10 Coding


• Medicare And Medi-Cal Proficiency


• Claims Processing

ATS Optimization Keywords

Hard Skills

• Billing Practices


• Regulatory Requirements


• UB-04 Claim Forms


• HCFA 1500 Claim Forms


• Account Follow-Up Resolution


• Medical Terminology

Soft Skills

• Problem Solving


• Adaptability


• Analytical Skills

Industry Keywords

• Multi-Specialty Practice


• Ambulatory Care