Patient Account Representative III - Professional Billing (Full Time, Day)

NorthBay Healthcare Group; Fairfield (CA); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

Education reimbursement

Professional development

Job summary

NorthBay Health is seeking an experienced Patient Account Representative III to oversee accurate and timely billing, follow-up, and collection of ambulatory patient accounts. You will ensure compliance with CPT/ICD coding, payer contracts, and regulatory requirements.

Responsibilities include timely claim processing, denial resolution, backlog management, and maintaining a professional, customer-focused approach while collaborating with the Patient Financial Services team.

Qualifications

• Minimum 5 years in professional billing with CPT/ICD/HCPCS knowledge.
• Understanding of payer contracts, payment structures, and federal/state regulations.
• Proficiency with compliance and collection laws.
• Excellent oral and written communication skills.
• Strong analytical skills with attention to detail.

Responsibilities

• Follow-up on accounts with practices, payers, and patients until a zero balance is achieved.
• Monitor accounts receivable to meet AR aging goals.
• Process initial billing claims promptly and resolve edits.
• Resolve payer denials to maximize reimbursement.
• Assist with backlogs and support departmental needs.
• Participate in workload reassignments to address priorities.
• Deliver excellent customer service with professional demeanor.
• Respond to inquiries accurately and timely.

Skills

Billing proficiency

CPT/ICD knowledge

Communication

EMR/EHR

Billing systems

Time management

Customer service

Teamwork

Education

High School Diploma or equivalent

Tools

EMR/EHR

Billing systems

Job description

Job Description

Under the direction of the Patient Financial Services Manager, the Patient Account Representative III (PAR-III) is responsible for the accurate and timely billing, follow-up, and collection of ambulatory patient accounts. This role ensures accounts are processed in accordance with standard and NorthBay-specific billing practices, as well as all applicable regulatory requirements.

Primary Responsibilities

• Perform timely follow-up on accounts with practices, payers, and/or patients until a zero balance is achieved per contract and payment expectations.
• Monitor and manage assigned accounts receivable to meet or exceed AR aging goals.
• Process all initial billing claims promptly, including resolution of edits.
• Address and resolve payer denials efficiently to maximize reimbursement.
• Assist with backlogs and other duties as assigned to support departmental needs.
• Participate in workload reassignment to address priority areas.
• Deliver excellent customer service by maintaining a pleasant, professional demeanor and managing conflict resolution promptly.
• Respond to verbal and written inquiries accurately and in a timely manner.

Qualifications

Education Requirements

• High School Diploma or equivalent.

Experience Requirements

• Minimum 5 years of experience in professional billing, with in-depth knowledge of CPT, ICD, and HCPCS coding.
• Understanding of payer contracts, payment structures, and federal/state regulations.
• Proficiency with compliance and collection laws.

Skills & Competencies

• Excellent oral and written communication skills.
• Proficiency in PC applications, EMR/EHR, and billing systems.
• Strong analytical skills with attention to detail.
• Effective time management and ability to prioritize multiple tasks.
• Strong customer service skills, with the ability to resolve concerns diplomatically.
• Commitment to NorthBay's True North values.
• Team-oriented mindset with a collaborative approach to problem-solving.
• Ability to maintain professionalism and tact in all interactions.

Performance Standards

• Ensure timely and accurate billing, claim edits, and follow-up.
• Apply sound analytical skills in researching and resolving claim issues.
• Utilize all available resources, tools, and systems consistently.
• Actively participate in team collaboration to overcome claim barriers.
• Support special projects, attend meetings, and participate in training opportunities.
• Meet assigned quality and productivity standards consistently.
• Manage time effectively to achieve productivity requirements.
• Adhere to departmental expectations regarding breaks, time-off requests, shift assignments, and attendance.
• Maintain confidentiality and professional communication at all times.
• Comply with facility-wide policies, safety guidelines, emergency protocols, applicable laws, and payer contracts.
• Uphold professional standards in conduct and performance.
• Demonstrate adaptability and willingness to assist in cross-functional initiatives as needed.

Certification Requirement

• All new hires will be required to complete the HFMA Certified Revenue Cycle Representative (CRCR) training course within the first nine (9) months of employment. Membership, training, and certification costs will be sponsored by the employer.

About Us

Interpersonal Skills and Values

Demonstrates NorthBay Health’s True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care.

Why NorthBay Health

NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.

We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions.

We are committed to being the trusted healthcare partner of choice and offer an environment where employees can grow, contribute meaningfully, and support the health of our communities.

NorthBay Health Benefits Options

NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability, and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance.

Compensation Structure

NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1–5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements.

Remote Work Disclosure

NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs.

Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States.

Notice to Recruitment Agencies

NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians, or hiring managers regarding recruitment or job postings.

More Information

Visit NorthBay Health Careers for recruitment FAQs and additional information.