Revenue Cycle Patient Account Representative I
Core
Supports Saint Francis Health System by ensuring patients experience clear, accurate, and timely resolution of their accounts, reducing financial stress through correct insurance claim processing and efficient issue resolution.
Role type
Patient Account Representative I
Builds
Patient account outcomes and revenue cycle efficiency
Domain
Healthcare / Medical Billing & Insurance
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Medical billing and insurance follow-up processes, Insurance coverage verification, Claims review and rejection research, Payer portal navigation, HIPAA compliance, No Surprise Act compliance, Account balance follow-up, Denial and underpayment resolution via appeals and rebills, Demographic data updates, Trend monitoring for revenue cycle optimization
Preferred skills
Health insurance field experience, Microsoft 365 proficiency, Epic system navigation
Technologies
Epic, Payer portals, Microsoft 365
Responsibilities
Verifies insurance coverage and ensures accurate representation of information on patient accounts; Processes tasks such as reviewing, handling follow-up actions, and ensuring timely resolution of work queue items; Reviews claims for accuracy, monitors electronic transmissions, researches rejections, and ensures proper posting of payments and adjustments; Conducts follow-up on outstanding balances by contacting insurance carriers, patients, and other stakeholders; Resolves denials and underpayments through appeals, rebills, and corrected claims; Identifies and addresses billing, coding, or demographic issues; Maintains compliance with state, federal, and payer requirements, applying knowledge of Medicare, Medicaid, commercial, and managed care payers; Monitors trends, system issues, and payer behaviors to prevent delays, reduce aging, and support efficient revenue cycle operations.
Seniority
Entry-level, individual contributor