Patient Account Representative II

🕒 6 days ago

🏄 California – Remote

🏄 California – Remote

💵 $33 - $38 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💰 Account Manager

🚫👨‍🎓 No degree required

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Stanford Health Care

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1885

🏥 Healthcare

⚕️ Healthcare Insurance

📚 Education

Healthcare • Healthcare Insurance • Education

Stanford Health Care is a major academic medical center affiliated with Stanford Medicine. It provides world-renowned patient care, emphasizes innovation and research, and offers a wide range of clinical services and career opportunities across nursing, advanced practice, allied health, laboratory, technology, administration, and other areas. The organization promotes values such as C-I-CARE (respect, courtesy, personal connection), sustainability, dedication, and community collaboration across physicians, researchers, professors, and students to advance health, healing, and knowledge globally.

📋 Description

• Process insurance-balance patient claims accurately and on time according to contracts and policies • Resolve unpaid, underpaid, denied, or unresolved patient accounts • Respond to payer requests by providing medical records or other documentation through mail or payer portals • Follow up on unresolved patient accounts in Epic by phone or payer portal • Resolve claim edits and payer variances, including pursuing underpayments • Review and resolve payer rejections and denials and perform basic appeals • Edit and submit electronic or hardcopy claims to payers • Recognize potential trends and escalate them appropriately • Post payments and related adjustments in Epic • Resolve credit balances and complete basic charge corrections

🎯 Requirements

• High school diploma or GED equivalent • Two (2) years of progressively responsible and directly related work experience • Meet weekly individual productivity goals and standards while following planned priorities • Maintain professional communication with PFS staff, payers, and patients • Follow oral and written instructions and accurately interpret institutional and other policies • Communicate clearly and professionally verbally and in writing • Maintain confidentiality of sensitive information • Perform basic mathematics • Plan, prioritize, and meet deadlines • Work effectively with individuals at all organizational levels • Knowledge of accounts receivable software systems and medical billing operations • Familiarity with medical reimbursement policies, procedures, and medical terminology • Knowledge of the payer landscape, including Medicare, Medicaid, Workers’ Compensation, Managed Care, or commercial insurance • Strong working knowledge of systems and processes • Resolve standard queries and problems independently and handle moderately complex assignments requiring critical thinking