Patient Accounts Rep - PFS Hospital

Kettering Health Network; Miamisburg (OH); On-site; USD 42,000 - 56,000; Full time

Job summary

PFS Hospital is hiring a remote, full-time Patient Account Rep I to support patient access and revenue cycle operations. The role focuses on accurate claims submission, payment posting, and account resolution, with emphasis on regulatory compliance and clear patient communication.

Ideal candidates have 1–2 years in medical billing, CPT/ICD-10 knowledge, and familiarity with Epic or similar practice management software. Join a team aligned with Kettering Health standards.

Qualifications

• High school diploma or equivalent required.
• 1–2 years in medical billing, collections, or related area.
• Knowledge of medical billing and coding principles (CPT, ICD-10).
• Familiarity with insurance verification and claims processing.
• Ability to use billing and practice management software (e.g., Epic).
• Strong attention to detail and data entry accuracy.
• Excellent written and verbal communication; able to resolve account discrepancies.
• Knowledge of HIPAA and patient confidentiality requirements.

Responsibilities

• Prepare, review, and submit medical claims to insurance carriers with accurate codes.
• Post patient and insurance payments, adjustments, and refunds promptly.
• Reconcile patient accounts and resolve outstanding balances.
• Verify patient insurance eligibility and benefits prior to services.
• Respond to patient inquiries regarding balances and payment options.
• Investigate and resolve denied claims and submit appeals as needed.
• Maintain confidentiality per HIPAA and privacy policies.
• Document all account activity and actions in the system.
• Collaborate with staff to resolve billing or account issues affecting patient experience.
• Participate in ongoing training on billing regulations and compliance.

Skills

Billing & collections

CPT/ICD-10 knowledge

Epic or similar PMS

HIPAA compliance

Data entry accuracy

Customer service communication

Account reconciliation

Education

High school diploma or equivalent

Tools

Epic or similar systems

Job description

Job Details

PFS Hospital | Remote | Full-time | First Shift

Responsibilities & Requirements

The Patient Account Rep I supports patient care access and operational reliability by performing billing and collections functions within the revenue cycle. This role ensures accurate processing of claims, payment posting, and patient account resolution, while providing clear communication to patients and maintaining regulatory compliance. Performs other duties as assigned. All job responsibilities are to be carried out in alignment with Kettering Health's mission, vision, values, and B Safe program.

Required Education

• High school diploma or equivalent.

Required Work Experience

• 1-2 years of experience in medical billing, collections, or a related area.

Skills

• Knowledge of medical billing and coding principles (CPT, ICD-10).


• Familiarity with insurance verification and claims processing.


• Ability to use billing and practice management software (e.g., Epic or similar systems).


• Strong attention to detail and accuracy in data entry.


• Effective written and verbal communication skills.


• Ability to resolve account discrepancies and provide customer service.


• Basic math and reconciliation skills.


• Understanding of HIPAA and patient confidentiality requirements.

Essential Functions

• Prepare, review, and submit medical claims to insurance carriers, ensuring accuracy of billing codes and patient information.


• Post patient and insurance payments, adjustments, and refunds to appropriate accounts in a timely manner.


• Reconcile patient accounts, investigate discrepancies, and resolve outstanding balances through follow-up and account review.


• Verify patient insurance eligibility and benefits prior to services to ensure correct billing and co-payment collection.


• Respond to patient inquiries regarding account balances, payment options, and billing questions, providing clear and courteous assistance.


• Investigate and resolve denied insurance claims by identifying errors, gathering required documentation, and submitting appeals as needed.


• Maintain strict confidentiality of patient information and comply with all HIPAA regulations and organizational privacy policies.


• Document all account activity, communications, and actions taken in the appropriate system or record.


• Collaborate with clinical and administrative staff to resolve billing or account issues affecting patient experience or payment.


• Participate in ongoing training related to billing regulations, insurance processes, and compliance standards.

Preferred Qualifications

• Associate's degree or coursework in healthcare administration, business, or related field.


• Experience in a healthcare setting with knowledge of medical billing software and insurance processes.


• Coding certification (e.g., CPC) or related credential.

Overview

Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio.Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.