Patient Accounts Specialist: Payments & Denials Expert

Pueblo Community Health Center, Inc.; Pueblo (CO); On-site; USD 52,149,048 - 61,319,731; Full time

Job summary

Pueblo Community Health Center, Inc. is seeking a Patient Accounts Representative to submit claims, analyze payer denials, and resolve unpaid claims, while posting payments accurately and timely.

The role reports to the Patient Accounts Manager and requires a high school diploma or equivalent, one year of medical billing experience, familiarity with Medicaid/Medicare and third‑party payers, plus a valid driver’s license.

Qualifications

• High School Diploma or equivalent required.
• One year medical billing experience required.
• Experience with Medicaid, Medicare, HMOs/POs and/or other third party payers.
• Valid driver’s license and auto insurance as required by law.

Responsibilities

• Submit daily electronic claims and paper claims to clearinghouse and insurance payers.
• File all applicable insurance forms for Center’s patients.
• Process appeals, refund requests and inquiries; make necessary adjustments to accounts to comply with programs and carriers.
• Analyze account balances to accurately bill patients for balance due.
• Assist patients with billing questions.
• Review insurance aging reports to identify unpaid claims for resolution.
• Arrange payment schedules with patients for past due accounts.
• Inform Patient Account Manager of any noncompliance issues.
• Assist in training of new Patient Accounts Representatives and participate in cross training.
• Participate in department and General Staff Meetings.
• Work outstanding tasks for encounter resolution in practice management system.
• Make inquiries via telephone or payer websites on patient encounters for payment resolution.

Education

High School Diploma or equivalent

Job description

Pueblo Community Health Center, Inc. is seeking a Patient Accounts Representative to submit claims, analyze payer denials, and resolve unpaid claims, while posting payments accurately and timely.

The role reports to the Patient Accounts Manager and requires a high school diploma or equivalent, one year of medical billing experience, familiarity with Medicaid/Medicare and third‑party payers, plus a valid driver’s license.