Job Description

Patient Account Representative (Remote Claims & Revenue Cycle)

Compensation: $25.00/hour

Location: FULLY REMOTE (Must live in Washington State)

Schedule: Full-Time, Monday Friday, 9:30 AM 6:30 PM

We are seeking a highly specialized and detail-oriented Patient Account Representative to manage the full cycle of medical disability benefits, claims processing, and patient account collections. This role is essential for ensuring maximum reimbursement and financial security for our members and patients. The coordinator will interpret complex state/federal regulations, audit medical documentation, and perform collections while maintaining the highest level of professional communication.

Key Responsibilities

This position requires extensive interaction with medical records, billing systems, and external payers:

• Claims Processing & Auditing: Receives, reviews, and controls requests for medical information, visit records, and notes. Audits, abstracts, and summarizes pertinent data from patient medical records to process insurance claims and reports in compliance with state/federal regulations.
• Financial & Collections Management: Collects monies owing from third-party payers, employers, and patients/guarantors. Contacts debtors by phone/correspondence to arrange payments, abiding strictly by all state and federal collection laws and regulations.
• Documentation & Adjustment: Prepares and audits visit records using various fee schedules, CPT-4, and ICD-9-CM coding conventions. Generates and records appropriate adjustments, researching all available sources to determine their validity.
• System Maintenance: Documents all collection action taken on individual accounts in the computer system, including promised payments and insurance filing dates. Performs skip tracing and demographic updates as needed.
• Coordination & Communication: Acts as a representative to communicate and correspond effectively with insurance carriers, doctors, members, and outside providers to ensure proper and adequate exchange of data and maximization of payments.

Required Qualifications

• Experience: Minimum one (1) year of collections or medical insurance claims processing experience.
• Related Experience: We are highly interested in candidates with prior experience working within large, complex health plan organizations.
• Core Skills: Demonstrated ability to perform diversified clerical functions, basic accounting procedures, and highly effective communication (written and verbal). Must have a strong ability to work independently without direct supervision in a fast-paced environment.
• Technical Proficiency:
• Proficiency in Microsoft Excel and Outlook .
• EPIC (HealthConnect) experience is REQUIRED for a quick start.

Preferred Qualifications

• Two (2) or more years of collections experience in the healthcare field.
• Knowledge of medical terminology, CPT-4, and ICD-9-CM coding.
• Knowledge of mainframe collections applications and 10-key by touch.

Top Three Daily Duties

1. Supporting schedule maintenance and changes for medical providers.
2. Processing insurance claims and reports for compensation.
3. Collecting monies owing and performing follow-up with insurance companies/agencies.

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