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Pyramid Consulting

Patient Account Representative

pomona, CA

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Job description

Patient Account RepresentativeImmediate need for a talented Patient Account Representative. This is a 13 months contract opportunity with long-term potential and is located in Pomona, CA (Onsite).Key Responsibilities:Review accounts receivable aging reports and prioritize collection activitiesFollow up with insurance carriers regarding outstanding hospital claimsPerform collections and follow-up for institutional (UB-04) facility claimsInvestigate, correct, and appeal denied or underpaid claims to maximize reimbursementCoordinate with billing and other internal departments to resolve claim discrepanciesAccurately document all collection and follow-up activities in the billing systemVerify patient insurance eligibility through payer websites, insurance portals, and customer service representativesMaintain compliance with HIPAA, organizational policies, and applicable state and federal regulationsKey Requirements and Technology Experience:Experience with Hospital Accounts Receivable (AR)Experience with Healthcare/Medical CollectionsExperience with UB-04 (Institutional/Facility) ClaimsExperience with Inpatient & Outpatient CollectionsExperience with Insurance Follow-Up / Facility Claims1-3 years of experience in hospital accounts receivable, medical collections, or healthcare collectionsRequired experience with both inpatient and outpatient collectionsExperience handling UB-04 (Institutional/Facility) claimsExperience collecting facility claims across multiple lines of businessWorking knowledge of hospital billing processes, CPT, ICD, and DRG reimbursement methodologiesFamiliarity with Medicare, Medicaid/Medi-Cal, and commercial insurance payer guidelinesStrong communication and negotiation skills for interacting with insurance payersProficiency with hospital billing/follow-up systems and Microsoft OfficeExcellent analytical skills with the ability to identify claim denials, payment variances, and reimbursement opportunitiesStrong attention to detail and organizational skillsHigh School Diploma or GED required

Worksite address

pomona, CA, 91766, US

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