Patient Account Representative I

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Day - 08 Hour (United States of America)

This is a Stanford Health Care job.

A Brief Overview
The Patient Account Representative I (PAR I) is responsible for the timely and accurate processing of patient accounts receivable billing and collections. The specific job duties will be comprised of a combination of responsibilities from among the various areas of PFS operations including Charge entry and charge batch balancing, Electronic and hardcopy claims editing and submission to various payers (Government, Managed Care, and Commercial), Accounts receivable collections and payer follow-up, Payer denial review and appeals processing, Customer service, Payment applications, Credit balance review and resolution and Patient advocacy and risk management. The PAR I position is an entry-level position. Under initial close supervision, performs simple, often repetitive and routine duties. Responds to simple queries/issues, but recognizes deviation from accepted practice and refers non-routine issues to others. Works on assignments that are routine in nature where limited judgment is required. Normally receives detailed instructions on all work.

What you will do
  • Account Reps: Follows up on unpaid accounts in patient accounting systems with the payers either by phone or via websites. Works payer denials based on claim process adjudication; Review accounts for possible underpayments; research contracts, guidelines and resolve payment with payer. Perform appeals with payer. Performs bad debt request transfers as applicable. Performs or requests adjustment and contractual write offs as applicable.
  • Billers: Reviews EPIC worklists and edits accounts as needed; Reviews Cirius claim edits and resolves edits; Reviews and resolves electronic acknowledgement payer rejections/denials; Rebills claims based on requests from Follow Up reps due to denials received. Resends claim as needed.
  • Cash Posting Reps: Posts payments; Work EPIC undistributed payment worklist; Posts adjustments related to payments. Processes refunds for accounts payable. Posts payment transfers from professional billing to hospital billing.
  • Data Control Reps: Enters charges; Reviews EPIC worklist accounts with charge issues and resolves;
  • Researches charge issues and follows up with departments as needed. Complete charge corrections including adding diagnosis, transferring or reversing charges, combining accounts.
  • Maintains professional communication with various PFS staff, medical center staff, payors, physicians, and patients regarding the billing of services rendered at Stanford Medical Center. Communication may consist of telephone, correspondence, or in person contact.
  • Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager/Coordinator.
  • Patient Advocacy Reps: Completes and processes charity applications; Reviews and validates high dollar self pay accounts before outsourcing to outside vendor; Handles patient calls and complaints. Requests referral of
    accounts to bad debt as applicable.

Education Qualifications
  • High School diploma or GED equivalent

Experience Qualifications
  • 1 year experience working in healthcare (i.e. admitting, medical records, physicians office, healthcare payer/insurance) or completion of a medical billing trade school certificate or 2+ years experience working in accounting within a non-healthcare industry (banking, finance, etc.)

Knowledge, Skills, and Abilities
These are the observable and measurable attributes and skills required to perform successfully the essential functions of the job and are generally demonstrated through qualifying experience, education, or licensure/certification.

Ability to follow oral and written instructions and interpret institutional and other policies accurately.
Ability to gather, analyze, and display data in appropriate format and keep accurate records.
Ability to maintain confidentiality of sensitive information.
Ability to perform basic mathematics.
Ability to plan, prioritize and meet deadlines.
Ability to work effectively with individuals at all levels of the organization.
Knowledge of billing and account records maintenance procedures.
Knowledge of computer systems and software used in functional area.
Knowledge of medical terminology and insurance claim procedures common to medical billing and accounts receivable operations.
Knowledge of principles and practices of customer service and telephone courtesy.

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford's patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family's perspective:

  • Know Me: Anticipate my needs and status to deliver effective care
  • Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
  • Coordinate for Me: Own the complexity of my care through coordination


Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.