Patient Account Representative II

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Stanford Health Care

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1885

🏥 Healthcare

Healthcare

Stanford Health Care is a major academic medical center and integrated hospital system delivering comprehensive clinical care, specialty services, and patient support. The organization operates hospitals, outpatient clinics and programs, offers clinical trials and telehealth (video visits), and provides patient-facing services such as a MyHealth patient portal, billing/insurance assistance, and resources for referring physicians, nurses and allied health professionals. It also engages with the community through donations, visitor services, and COVID-19 resources.

📋 Description

• Respond to payer requests by providing medical records or other documentation via mail or payer portals • Follow up on unresolved patient accounts in Epic by contacting payers by phone or portal • Resolve claim edits • Review payer variances and pursue underpayments • Review and resolve payer rejections and denials, and perform appeals as necessary • 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 • 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 and procedures and medical terminology • Knowledge of payer landscape, including Medicare, Medicaid, Workers’ Compensation, Managed Care, or commercial insurance • Strong working knowledge of systems and processes • Ability to resolve standard queries and problems independently and handle moderately complex assignments requiring critical thinking