Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote
Not Disclosed•Full-TimeHybrid
location_onTwo Procter & Gamble Plaza, 2, Procter & Gamble Plaza, Procter & Gamble General Office, Central Business District, Cincinnati, Hamilton County, Ohio, 45202, United States
About the Role
Under the direction of the Revenue Cycle Manager and Supervisor, the Patient Account Representative serves as a critical link in the healthcare financial ecosystem. This role is dedicated to monitoring insurance claims that lack response, remain pending, or face denial and appeal. The primary mission is to proactively resolve balances billed to insurance carriers through accurate claim adjudication.
Beyond standard claim processing, this position evaluates and resolves issues regarding under or over payments and manages refund requests from insurance carriers. The role requires a deep understanding of the Healthcare Revenue Cycle, specifically within the Physician Revenue Cycle, to effectively navigate medical billing and insurance reimbursement methods.
A Day in the Life
Success in this role demands a blend of analytical rigor and independent self-management. You will spend your time analyzing Insurance Explanation of Benefits, ensuring compliance with basic Medicare, Medicaid, and Commercial billing rules, and applying effective research methods to uncover payment discrepancies. The work environment is fast-paced and occasionally stressful, requiring you to prioritize tasks, make independent decisions based on report requirements, and maintain diplomatic communication with various stakeholders.
While the position is primarily remote, flexibility is essential. You may occasionally be required to work from a normal office environment or travel to various hospitals to support business needs. Regular and predictable attendance is mandatory for both remote and in-office duties, with work hours that may vary to meet the dynamic needs of the business.
Hiring Process
Candidates must demonstrate a comprehensive understanding of the Healthcare Revenue Cycle, including the CMS-1500 claim form components and coding requirements. Experience with Epic Revenue Cycle or other healthcare operating systems, as well as proficiency in various Payer Portals and regulatory systems, is highly valued. The ideal candidate possesses strong organizational skills, computer literacy, and the ability to work effectively in a team-oriented environment while maintaining meticulous attention to detail.
Work location
Work model: Hybrid
Two Procter & Gamble Plaza, 2, Procter & Gamble Plaza, Procter & Gamble General Office, Central Business District, Cincinnati, Hamilton County, Ohio, 45202, United States
Cincinnati, Ohio
Key Responsibilities
- check_circleResolve balances billed to insurance carriers through accurate claim adjudication
- check_circleEvaluate and resolve under or over payments and insurance carrier refund requests
- check_circleDocument research and actions thoroughly with accurate and comprehensive records
- check_circleResearch regulatory systems and utilize payer portals for claim follow-up
- check_circleMonitor insurance claims for no response, pending response, denial, and appeal status
- check_circleApply Medicare, Medicaid, and commercial billing and compliance rules
- check_circleAnalyze Insurance Explanation of Benefits to verify payment accuracy
Requirements
- verifiedHigh School Diploma or GED
- verified2 years in Healthcare Revenue Cycle
- verifiedExperience with Epic Revenue Cycle or other Healthcare operating systems
- verifiedExperience with MS Suite, emphasis in Excel
- verifiedUnderstanding of CMS-1500 claim form and components
- verifiedUnderstanding of basic coding requirements for CMS-1500
- verifiedAbility to read and understand Insurance Explanation of Benefits
- verifiedExperience with basic Medicare, Medicaid, and Commercial billing
- verifiedExperience with various Payer Portals and regulatory systems
Nice to Have
Experience in Physician Revenue Cycle.
Similar Job Opportunities
Skills, education and keywords
Skills: Healthcare Revenue Cycle, Medical Billing, Insurance Reimbursement, CMS-1500 Claim Form, Coding, Medicare, Medicaid, Epic Revenue Cycle, Payer Portals, MS Suite.
Education: High School Diploma or GED required.
Frequently asked questions about Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote at UC Health
What does a Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote at UC Health do?expand_more
Day-to-day, the Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote at UC Health will resolve balances billed to insurance carriers through accurate claim adjudication; evaluate and resolve under or over payments and insurance carrier refund requests; document research and actions thoroughly with accurate and comprehensive records; and research regulatory systems and utilize payer portals for claim follow-up.
What are the requirements for this Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote role?expand_more
To qualify for the Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote at UC Health position, applicants should have: High School Diploma or GED; 2 years in Healthcare Revenue Cycle; Experience with Epic Revenue Cycle or other Healthcare operating systems; Experience with MS Suite, emphasis in Excel; Understanding of CMS-1500 claim form and components; and Understanding of basic coding requirements for CMS-1500.
Where is the Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote role at UC Health located?expand_more
Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote at UC Health is based in Two Procter & Gamble Plaza, 2, Procter & Gamble Plaza, Procter & Gamble General Office, Central Business District, Cincinnati, Hamilton County, Ohio, 45202, United States. This is a hybrid role.
Is this Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote job remote, hybrid, or on-site?expand_more
UC Health has listed this Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote role as hybrid.
How much experience is required for this Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote role?expand_more
Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote at UC Health typically requires 2+ years of relevant experience at the mid level level.
What skills do you need for the Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote role at UC Health?expand_more
Key skills for Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote at UC Health include Healthcare Revenue Cycle; Medical Billing; Insurance Reimbursement; CMS-1500 Claim Form; Coding; Medicare; Medicaid; and Epic Revenue Cycle.
What education is required for Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote at UC Health?expand_more
Educational requirements for this role: High School Diploma or GED required.
What category does the Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote role belong to?expand_more
Patient Accounting Representative, PBO Follow Up, First Shift, Full Time, Remote at UC Health is part of the accounting & finance job category on Recrutus.
About UC Health
UC Health, headquartered in Cincinnati, OH, delivers comprehensive healthcare services through a network of clinical expertise and research innovation. The organization operates key facilities including UC Medical Center and West Chester Hospital, offering advanced medical care supported by the academic resources of the University of Cincinnati, a top-tier public research institution. Focused on Hospitals and Health Care, UC Health emphasizes patient-centered treatment across a range of specialties, blending clinical excellence with educational and research initiatives. The organization prioritizes compassionate care and innovative approaches to improve health outcomes for communities locally and beyond. Committed to fostering an inclusive workplace, UC Health upholds equal opportunity employment principles, welcoming diverse talent across medical and support roles. Career opportunities span clinical practice, research, education, and administrative functions, reflecting the organization’s dedication to advancing healthcare through collaboration and discovery.
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