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Patient Account Representative Jobs in California

Patient Account Representative III - Professional Billing (Full Time, Day)

Northbay
  • Fairfield, CA
  • Instant Apply
30 days ago

Job Description

Under the direction of the Patient Financial Services Manager, the Patient Account Representative III (PAR-III) is responsible for the accurate and timely billing, follow-up, and collection of ambulatory patient accounts. This role ensures accounts are processed in accordance with standard and NorthBay-specific billing practices, as well as all applicable regulatory requirements. 

The PAR-III manages patient accounts across multiple services and specialties within NorthBay Ambulatory practices and plays a key role in achieving optimal reimbursement outcomes and maintaining compliance with healthcare billing standards.

Primary Responsibilities

  • Perform timely follow-up on accounts with practices, payers, and/or patients until a zero balance is achieved per contract and payment expectations.
  • Monitor and manage assigned accounts receivable to meet or exceed AR aging goals.
  • Process all initial billing claims promptly, including resolution of edits.
  • Address and resolve payer denials efficiently to maximize reimbursement.
  • Assist with backlogs and other duties as assigned to support departmental needs.
  • Participate in workload reassignment to address priority areas.
  • Deliver excellent customer service by maintaining a pleasant, professional demeanor and managing conflict resolution promptly.
  • Respond to verbal and written inquiries accurately and in a timely manner.

Numbers & Facts

LocationFairfield, CA

Qualifications

Education Requirements

  • High School Diploma or equivalent.

 

Experience Requirements

  • Minimum 5 years of experience in professional billing, with in-depth knowledge of CPT, ICD, and HCPCS coding.
  • Understanding of payer contracts, payment structures, and federal/state regulations.
  • Proficiency with compliance and collection laws.

 

Skills & Competencies

  • Excellent oral and written communication skills.
  • Proficiency in PC applications, EMR/EHR, and billing systems.
  • Strong analytical skills with attention to detail.
  • Effective time management and ability to prioritize multiple tasks.
  • Strong customer service skills, with the ability to resolve concerns diplomatically.
  • Commitment to NorthBay's True North values.
  • Team-oriented mindset with a collaborative approach to problem-solving.
  • Ability to maintain professionalism and tact in all interactions.

 

Performance Standards

  • Ensure timely and accurate billing, claim edits, and follow-up.
  • Apply sound analytical skills in researching and resolving claim issues.
  • Utilize all available resources, tools, and systems consistently.
  • Actively participate in team collaboration to overcome claim barriers.
  • Support special projects, attend meetings, and participate in training opportunities.
  • Meet assigned quality and productivity standards consistently.
  • Manage time effectively to achieve productivity requirements.
  • Adhere to departmental expectations regarding breaks, time-off requests, shift assignments, and attendance.
  • Maintain confidentiality and professional communication at all times.
  • Comply with facility-wide policies, safety guidelines, emergency protocols, applicable laws, and payer contracts.
  • Uphold professional standards in conduct and performance.
  • Demonstrate adaptability and willingness to assist in cross-functional initiatives as needed.

 

Certification Requirement

  • All new hires will be required to complete the HFMA Certified Revenue Cycle Representative (CRCR) training course within the first nine (9) months of employment. 
  • Membership, training, and certification costs will be sponsored by the employer.

Skills

  • Accounts Receivableunmatched
  • Accounts Receivable Managementunmatched
  • Billingunmatched
  • Conflict Resolutionunmatched
  • Customer Support/Serviceunmatched
  • Exceeded Sales Goalunmatched
  • Financial Servicesunmatched
  • Healthcare Reimbursementunmatched
  • Maintain Complianceunmatched
  • Medical Billingunmatched
  • Regulatory Requirementsunmatched
  • Reimbursementunmatched
  • Time Managementunmatched

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