Patient Accounts Rep - PFS Hospital

Job description

Job Details
PFS Hospital | Remote | Full-time | First Shift
Responsibilities & Requirements
The Patient Account Rep I supports patient care access and operational reliability by performing billing and collections functions within the revenue cycle. This role ensures accurate processing of claims, payment posting, and patient account resolution, while providing clear communication to patients and maintaining regulatory compliance. Performs other duties as assigned. All job responsibilities are to be carried out in alignment with Kettering Health's mission, vision, values, and B Safe program.
Required Education
• High school diploma or equivalent.

Required Work Experience
• 1-2 years of experience in medical billing, collections, or a related area.

Skills
• Knowledge of medical billing and coding principles (CPT, ICD-10).
• Familiarity with insurance verification and claims processing.
• Ability to use billing and practice management software (e.g., Epic or similar systems).
• Strong attention to detail and accuracy in data entry.
• Effective written and verbal communication skills.
• Ability to resolve account discrepancies and provide customer service.
• Basic math and reconciliation skills.
• Understanding of HIPAA and patient confidentiality requirements.

Essential Functions
• Prepare, review, and submit medical claims to insurance carriers, ensuring accuracy of billing codes and patient information.
• Post patient and insurance payments, adjustments, and refunds to appropriate accounts in a timely manner.
• Reconcile patient accounts, investigate discrepancies, and resolve outstanding balances through follow-up and account review.
• Verify patient insurance eligibility and benefits prior to services to ensure correct billing and co-payment collection.
• Respond to patient inquiries regarding account balances, payment options, and billing questions, providing clear and courteous assistance.
• Investigate and resolve denied insurance claims by identifying errors, gathering required documentation, and submitting appeals as needed.
• Maintain strict confidentiality of patient information and comply with all HIPAA regulations and organizational privacy policies.
• Document all account activity, communications, and actions taken in the appropriate system or record.
• Collaborate with clinical and administrative staff to resolve billing or account issues affecting patient experience or payment.
• Participate in ongoing training related to billing regulations, insurance processes, and compliance standards.

Preferred Qualifications
• Associate's degree or coursework in healthcare administration, business, or related field.
• Experience in a healthcare setting with knowledge of medical billing software and insurance processes.
• Coding certification (e.g., CPC) or related credential.

Overview
Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.