Patient Billing Representative

PathGroup; Coppell (TX); On-site; USD 46,000 - 66,000; Full time

Job summary

PathGroup in Coppell, TX, is seeking a Patient Billing Representative to serve as a subject matter expert for patient billing inquiries, escalations, and issue resolution. This role focuses on delivering a positive patient experience while ensuring compliance with billing policies.

The ideal candidate will have 5+ years in customer service and healthcare billing, strong knowledge of EOBs, HIPAA, and insurance claim processing, and the ability to work independently as well as within a team.

Qualifications

• 5+ years of customer service and billing experience, preferably in healthcare.
• Understanding of Explanation of Benefits and patient billing workflows.
• Strong understanding of insurance claim processing to resolve patient billing inquiries.
• Excellent oral and written communication skills.
• Knowledge of HIPAA compliance.
• Proficiency with billing software and MS Office.
• Ability to work independently and collaboratively.
• Familiarity with Corporate Compliance Program and Privacy/Security policies.

Responsibilities

• Research escalated patient billing inquiries and resolve with internal/external resources.
• Monitor BBB inquiries and coordinate responses with management.
• Audit patient billing processes for accuracy and completeness.
• Identify trends in patient inquiries and suggest process improvements.
• Support the department in meeting call handling, patient satisfaction, and resolution goals.
• Triage inquiries via email or tracking system for timely resolutions.
• Provide courteous, professional service to patients and stakeholders.
• Handle other related duties or special projects as assigned.
• Adhere to security and regulatory guidelines to protect PHI.
• Follow Corporate Compliance Program and Corporate policies.

Skills

Customer service

Billing

Communication skills

HIPAA compliance

Problem-solving

Independence & collaboration

Education

High School Diploma or GED

Tools

Billing software

MS Office

Job description

JOB SUMMARY

The Patient Billing Representative serves as a subject matter expert and lead resource for patient billing inquires, escalations and issue resolution. This role ensures a positive patient experience while maintaining compliance with billing policies.

JOB RESPONSIBILITIES

ESSENTIAL FUNCTIONS

• Research complex or escalated patient billing inquiries and partner with internal and external resources to resolve.
• Monitor and research Better Business Bureau inquiries and collaborate with management on response.
• Audit and review patient billing process for accuracy and completeness.
• Communicate patient inquiry trends or issues to management and recommend process improvements.
• Support the department in meeting performance goals for call handling, patient satisfaction, and resolution time.
• Monitor and triage patient billing inquiries via email or tracking system to ensure timely and accurate resolution.
• Provide courteous and professional customer service to patients and all internal and external departments.
• Complete other related duties or special projects as assigned.
• Perform all job responsibilities in alignment with the industry's best security practices and regulatory guidelines to protect the confidentiality, integrity, and availability of protected health information and other sensitive company data.
• Must be familiar with and abide by the Corporate Compliance Program and all Corporate policies, including the Privacy and Security policies.

EDUCATION & LICENSURE

• High School Diploma or GED is required.

Qualifications

• 5+ years of customer service and billing experience, preferably in a healthcare or laboratory setting.
• Understanding of Explanation of Benefits and patient billing workflows.
• Strong understanding of insurance claim processing to be able to resolve patient billing inquiries.
• Excellent oral and written communication skills.
• Problem-solving skills to research and provide resolution.
• Knowledge of HIPAA compliance.
• Proficiency with billing software and MS Office.
• Ability to work independently and collaboratively.