Patient Accounts Representative

Nationwide Children's Hospital; North Carolina; Hybrid; USD 42,000 - 62,000; Full time

Job summary

Nationwide Children’s Hospital is seeking a detail-oriented Medical Billing Specialist to process patient accounts accurately and timely. You will review account information, update records, and follow up on claims with government and third-party payers to maximize reimbursement.

The role requires knowledge of CPT/ICD9 coding, strong data entry and problem-solving skills, and excellent communication. Prior billing experience and mainframe/ Outlook/ Excel proficiency are preferred.

Qualifications

• Knowledge of medical terminology and third-party payer billing.
• Experience with CPT and ICD9 coding and reimbursement rules.
• Proficient in data entry and calculations.
• Excellent written and verbal communication skills.

Responsibilities

• Review patient account information for accuracy and completeness.
• Update records and perform necessary changes to ensure timely payments.
• Follow up on claims, denials, and rejections with payers.
• Coordinate with payers and internal teams to maximize reimbursement.
• Maintain confidentiality of patient records.

Skills

Medical terminology

Claims follow-up

Data entry

Communication skills

Education

High school diploma

Associates degree preferred

Tools

Mainframe experience

Outlook/Word/Excel

Job description

Overview:

Schedule: Monday-Friday (Day Shift)

Fully on-site during probation period until approved to work hybrid.

Job Description Summary:

Responsible for the timely processing of duties and/or activities related to the accurate processing and handling of patient accounts. Ensures that all patient account information, charges, billings, and follow-up activities are accurate, complete, and timely.

Job Description:

Essential Functions:

• Reviews patient account information for completeness and accuracy.
• Makes necessary changes/updates to patient account information to ensure timely payment on accounts. Retrieves status information from government and third party payers regarding outstanding professional claims.
• Coordinates with governmental agencies, third-party payers, and internal auditors to ensure maximum reimbursement for hospital services.
• Acts as a liaison between the hospital and third party payers in resolving billing and reimbursement issues.
• Provides follow-up on claim edits, rejections, denials, and outstanding professional claims in a timely manner.
• Maintains patient records and ensures confidentiality of sensitive information.

Education Requirement:

• High school diploma, required.
• Associates degree, preferred.

Licensure Requirement:

(not specified)

Certifications:

(not specified)

Skills:

• Knowledge of medical terminology, various claim forms, third party contracts and payment patterns, CPT and ICD9 coding, and reimbursement regulations and policies of third party payers.
• The ability to do data entry and work a calculator.
• Problem identification and problem solving skills,required.
• Excellent interpersonal, verbal, and written communication skills.
• Excellent organization skills and the ability to comprehend and follow written and verbal instructions.

Experience:

• Two years’ experience in medical billing, claims follow-up and customer service, required.
• One year experience working on a mainframe computer. Experience using Outlook, Word and Excel, required.

Physical Requirements:

OCCASIONALLY: Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking

FREQUENTLY: Flexing/extending of neck, Patient Equipment, Peripheral vision

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Problem solving, Repetitive hand/arm use, Seeing – Far/near, Sitting

Additional Physical Requirements performed but not listed above:

(not specified)

“The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet”