Patient Account Representative

Job Description

Who We Are

As the largest and most comprehensive orthopaedic team in the state, we’ve combined the medical expertise of the state’s finest orthopaedic and musculoskeletal surgeons, specialists, and research pioneers. And along the continuum of care, every provider we work with feels a compelling commitment to leadership in education, innovation and research, as well as a dedication and desire to put each patient first.

Why Join Us?

Position Summary

The Patient Account Representative is responsible for ensuring a seamless financial experience for patients by verifying insurance eligibility, obtaining prior authorizations, and calculating cost estimates for upcoming procedures. This role involves clear communication with patients regarding their financial responsibility, processing payments, and setting up payment plans as needed. Additionally, the Patient Access Representative collaborates with insurance providers to confirm benefits, resolve billing disputes, and ensure compliance with insurance requirements. Strong attention to detail, customer service skills, and knowledge of insurance processes are essential for success in this role.

Duties and Responsibilities

Calculate and provide cost estimates for upcoming patient surgeries, including anticipated out-of-pocket expenses.

Verify insurance eligibility by collecting patient information and coordinating with insurance providers.

Obtain prior authorizations for procedures as required by insurance companies.

Calculate patient cost estimates, including anticipated out of pocket expenses and communicate financial responsibility

Process patient payments and set up payment plans for outstanding balances

Communicate with insurance companies via phone and online portals to confirm patient eligibility and benefits.

Process refunds or adjustments as needed

Address patient inquiries regarding billing statements, insurance coverage and payment options.

Investigate and resolve billing disputes with patients and insurance companies

Education, Experience, Licenses, and Certifications

High school diploma or general education degree (GED) required.

Associates degree or higher preferred.

1-2 years of experience in a healthcare setting.

Experience with insurance verification, claims processing, and billing procedures preferred

Familiarity with electronic medical records (EMR) systems and billing software

Knowledge of medical billing and coding (ICD-10, CPT, )

Understanding of insurance authorization procedures and insurance claim processing

Excellent customer service skills, including patience, empathy, and professionalism

Ability to handle difficult conversations regarding payments, billing disputes, and collections

Our company participates in E-Verify to confirm the employment eligibility of all newly hired employees, as required by federal law

Full-time