PATIENT ACCOUNTS REP

River Vista Behavioral Health; Madera (CA); On-site; USD 42,000 - 65,000; Full time

Job summary

River Vista Behavioral Health in California is seeking a Patient Account Representative to manage electronic and manual billings, follow-up with third‑party payers, and handle daily cash receipts and insurance logs.

The role emphasizes accuracy, timely correspondence, and maintaining confidentiality while preparing billing reports and supporting the hospital business office with denials, appeals, and patient account documentation.

Qualifications

• Minimum 3 years’ hospital or insurance billing experience.
• Experience with patient accounts and multiple software programs.
• Overtime and flexible hours may be required.
• Knowledge of Medicare/Medicaid policies a plus.

Responsibilities

• Submit insurance billings to primary and secondary payers.
• Prepare billing statements and conduct follow-up on outstanding balances.
• Maintain insurance logs and tickler/aging systems.
• Provide billing reports and support for the UM department.
• Ensure accuracy of UBS reviews and denial documentation.

Skills

Code procedures

Computers & software

Medicare/Medicaid policies

Time management

Telephone etiquette

Oral & written communication

Confidentiality

Team player

Adaptability

Emergency response

Education

High school diploma or equivalent

Tools

Computers

Office software

Job description

Position Summary

The Patient Account Representative is responsible for submitting electronic and manual billings, account statements, and for follow‑up with third‑party payers and patients for outstanding balances. The position also handles daily cash receipts and maintenance of insurance logs.

Responsibilities

• Prepare all accounts for billing and ensure account billing productivity standards are met
• Prepare and submit insurance billings to primary and secondary payers
• Prepare TAR forms for county authorization and billing
• Transmit all billings to third‑party payers, either manually or electronically as requested
• Assist in contacting third‑party payers at a 30‑day interval after billing to ensure that bills have been received and are being processed
• Assist in contacting third‑party payers on insurance billings at least twice every 30 days for payment status
• Correspondence is answered within 72 hours of receipt
• Maintain a current tickler and/or aging system for prompt follow‑up on billing cycles
• Document contacts on a productivity log
• Ensure account activity is current and accurately documented, including changing financial class of accounts for secondary insurance, completing denial notification notices, maintaining denial documentation, and providing chart documentation to UM department for review
• Prepare billing reports as required by the department
• Review all records and uniform billings (UBS) for third‑party payers for accuracy
• Provide follow‑up on appeals and prepare documentation as required
• Maintain Medicare and Medicaid statistical logs and databases
• Prepare departmental billing and statistical reports as required
• Provide back‑up support for other business office teammates
• Adhere to facility, department, corporate, personnel and standard policies and procedures
• Attend mandatory facility in‑services and staff development activities as scheduled
• Adhere to facility standards concerning conduct, dress, attendance and punctuality
• Support facility‑wide quality/improvement goals and objectives
• Maintain confidentiality of facility employees and patient information

Qualifications

Education

High school graduate or equivalent

Experience

A minimum of three (3) years’ experience in hospital and/or insurance billing is preferred. Any combination of education, training, or experience in a hospital business office is required. Experience with patient accounts, computers, and multiple business software programs is required.

Additional Requirements

May be required to work occasional overtime and flexible hours.

Knowledge, Skills, and Abilities

• Knowledge of all code procedures
• Knowledge of computers and business software
• Knowledge of commercial and governmental policies and guidelines (Medicare, Medi‑Cal, County, etc.)
• Skill in organizing and prioritizing workloads to meet deadlines
• Skill in telephone etiquette and paging procedures
• Effective oral and written communication skills
• Ability to communicate effectively with patients and co‑workers
• Ability to adhere to safety policies and procedures
• Ability to use good judgment and maintain confidentiality of information
• Ability to work as a team player
• Ability to demonstrate tact, resourcefulness, patience and dedication
• Ability to accept direction and adhere to policies and procedures
• Ability to adapt to the needs of various patient age groups (adolescent, adult, and geriatric)
• Ability to work in a fast‑paced environment
• Ability to react calmly and effectively in emergency situations
• Ability to meet corporate deadlines

Physical, Mental, and Special Demands

• Work a 40‑hour week
• Sit for long periods, up to 8 hours
• Use both hands for fine and gross manipulation of small tools (copier, computer, telephone, typewriter, calculator, safe, facsimile machine)
• Push and pull up to 10 lbs. (e.g., file cabinet drawers, computer paper boxes)
• See well enough to read handwritten and typewritten material
• Lift and carry up to 25 pounds to move transfer file boxes, data processing paper, and newly admitted patients’ belongings, as required
• Retrieve files from bottom shelves and drawers and move boxes of paper; reach, turn and twist above and below the waist daily to retrieve files from top shelves and obtain office supplies from upper shelves in supply closet
• Hear and speak well enough to answer and communicate on the hospital switchboard
• Spend 90% of working time in an environment of continuous low voices and office machine noise typical for a business office atmosphere
• Handle a variety of repetitive tasks

Machines, Tools, Equipment, and Other Work Aides

• Telephone, switchboard and paging systems
• Copy machine
• Computers and various software packages
• Calculator/10‑Key
• Facsimile machine
• Postage machine
• Policies, procedures, plans and program manuals