Patient Account Representative, Level II

🔥 2 hours ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

💰 Account Manager

🚫👨‍🎓 No degree required

👻 Ghost score 12%

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Regional One Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1829

🏥 Healthcare

🏨 Hospitality

📚 Education

Healthcare • Hospitality • Education

Regional One Health is a comprehensive health system and hospital network focused on delivering a wide range of medical services to its community. The organization operates multiple campuses and specialized centers—including the Elvis Presley Trauma Center, Firefighters Burn Center, Extended Care Hospital, Rehabilitation Hospital, Sheldon B. Korones Newborn Center, Center for Rehabilitative Medicine, Imaging Center, and primary care clinics—along with specialized programs in trauma, burn care, high-risk obstetrics, neonatal care, MR-guided focused ultrasound, oncology, orthopedics, outpatient surgery, primary care, rehabilitation, sickle cell, vascular care, and women's health. It offers patient-facing services such as a pharmacy app for prescription refills, patient portal (HealtheLife), financial assistance and insurance help, a foundation, residency and affiliate training programs, community outreach and education, and a population health strategy (ONE Health). The system emphasizes complex care, community health, innovation, a proposed large infrastructure ONE Campus project, and hosts events, podcasts, and research activities.

📋 Description

• Accurately and timely process patient accounts related to billing, collections and reimbursements for The Regional Medical Center according to PFS standards, policies and procedures • Make the required number and quality of collection calls per day • Secure required financial and demographic information for patient claims • Monitor, follow up on, and research assigned patient accounts • Provide courteous and professional customer service • Review erroneous claims and research commercial guidelines to make corrections and adjustments • Respond to patient and insurance company complaints, correspondence, inquiries and information requests • Coordinate with clinical departments and HIM to determine claim integrity and resolve claims • Update PFS management regarding errors, payer issues, registration issues and reimbursement-related activities • Research governmental requirements and implement regulatory billing changes • Collect balances from third-party payers in compliance with applicable laws • Meet daily productivity standards and clear billing, rebilling, correspondence, EOB, report and appeal files within specified timelines • Review and resolve suspended claims in electronic billing terminals • Work discount reports and make necessary corrections • Submit claims timely and avoid filing deadlines • Identify and forward denial information and resolve denials • Correct BAR tables to ensure accurate contractual adjustments • Verify payment accuracy against claims, charges, terms and procedures • Maintain thorough and ethical collection efforts • Collaborate with the team to distribute workload • Assess associate educational needs and provide training with PFS Managers • Communicate findings, recommendations and financial opportunities to PFS leadership • Participate in daily team briefings and metrics tracking

🎯 Requirements

• High School Diploma or equivalent • Minimum 2 years experience • Experience in facility reimbursement, including hospital billing, insurance collection, hospital payment validation, reimbursement verification and/or refunds for government and/or commercial insurances • College education, previous insurance company claims experience and/or health care billing experience may be considered in lieu of hospital experience • Knowledge of governmental mandated regulations pertaining to claims submission • Knowledge of billing and reimbursement requirements by payer • Ability to meet role-specific productivity standards • Ability to work within applicable state and federal collection laws • No travel required

🏖️ Benefits

• Equal opportunity employer, including veterans and people with disabilities • Fully remote work arrangement