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Full-time
high school, professional certificate
Posted 1d ago
~40 hrs/week
Remote in Reading, Pennsylvania, United States
Responsibilities
The Patient Account Representative manages collections, account follow-up, and billing allowance posting for assigned accounts. They are responsible for resolving outstanding claims, identifying denial trends, and initiating appeals while maintaining compliance with HIPAA standards.
Requirements
Candidates must have a High School Diploma and 2-3 years of experience in insurance collections, specifically with hospital or facility billing. Proficiency in healthcare claims processing, medical coding, and Microsoft Office is required, with a preference for Medical Billing and Coding certification.
Full job description
Job Purpose
The Patient Account Representative is responsible for collections, account follow up, billing allowance posting for the accounts assigned to them. This role requires Medicare/Medicaid experience.
Duties and Responsibilities
Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
Review and updates all patient and financial information accurately as given
Verify that information is accurate as to individual or insurance company responsible for payment of bill
Monitor all billings for accuracy, updating any errors
Monitor Medicaid/healthy options coupons to assure services are billed within expected timeframes
Bill all hospital services to primary insurer or patient correctly and within expected timeframe
Follow up with insurance companies on all assigned accounts within expected timeframe
Explain hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contracts
Identify and report underpayments and denial trends
Analyze, identify and resolve issues causing payer payment delays; Initiate appeals when necessary
Manipulate excel spreadsheets and communicate results
Meet and maintain daily productivity and quality standards established in departmental policies
Act professionally, cooperatively and courteously with patients, insurance payors, co-workers, management and clients
Maintain confidentiality at all times
Other duties as assigned
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications
High School Diploma or equivalent required
Medical Billing and Coding certification preferred, but not required
Experience in Hospital/Facility billing required
2-3 years’ experience in insurance collections, including submitting and following up on claims
Basic knowledge of healthcare claims processing including: ICD-9/10, CPT and HCPC codes, as well as UB-04
Ability to use various workflow system and client host system such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accounts
Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies
Understanding of government, Medicare and Medicaid claims
Basic math and typing skills
Proficiency with Microsoft Office Suite
Strong interpersonal skills, ability to communicate well at all levels of the organization
Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required
Working Conditions
Mustpossess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
Work Environment: The noise level in the work environment is usually minimal.
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
About Us: A leader in the Revenue Cycle Management (RCM) industry, we provide healthcare systems, hospitals, and healthcare providers with the right tools, technology, and services to improve the patient experience and revenue collections so they can focus on delivering the highest quality care to those they serve.
How: We accomplish that through proprietary cutting edge technology, advanced analytics, uncompromised service delivery, and highly-trained people who are passionate about getting it done, every day.
Explore Opportunities: Our goal is to provide every employee with opportunities to learn, to grow, to be challenged. To help you get there, we provide thorough skills training through Med-Metrix University based on your job responsibilities and experience level. And, you’ll work closely with your management team to ensure role-specific training, resources, and coaching. See how you can start – or grow – your career at Med-Metrix.
Offices: 9 Entin Road, Parsippany, New Jersey 07054, US · 19176 Hall Rd, Clinton Township, Michigan 48038, US · 331 Newman Springs Rd, Red Bank, New Jersey 07701, US · 100 Quentin Roosevelt Blvd, Garden City, NY 11530, US · 265 Spagnoli Rd, Melville, New York 11747, US
How many Administrative jobs are open in Reading, PA right now?
There are currently 150 open administrative positions in Reading, PA listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Administrative roles in Reading, PA?
Companies currently hiring include Albright College, Penske Truck Leasing, County of Berks, PA, Apis Services, Inc., City of Reading, PA, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Administrative jobs in Reading, PA?
Yes — 18 of the 150 open administrative positions offer remote or hybrid work (5 remote, 13 hybrid).
How do I apply for Administrative jobs in Reading, PA?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.