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Patient Account Representative II

Patient Account Representative II

Stanford Health CarePalo Alto, CA, US
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Patient Account Representative

The Patient Account Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies. The PAR works in various capacities to support the primary goal of the business office to resolve unpaid, underpaid, denied, or unresolved patient accounts. Depending on the specific team, the PAR's focus may be on a mix of various responsibilities from across the Patient Financial Services (PFS) operations. Responsibilities may include :

  • Responding to requests from the payer, such as providing medical records or other documentation either by mail or via payer portals
  • Following up on unresolved patient accounts in Epic by contacting the payer by phone or via the portal
  • Resolving claim edits
  • Reviewing payer variances and pursuing underpayments to payers
  • Reviewing and resolving payer rejections, denials, and performing appeals as necessary
  • Electronic or hardcopy claims editing and submission to payers
  • Recognizing potential trends and escalating them as appropriate
  • Posting payments in Epic, as well as related adjustments
  • Resolving credit balances
  • Completing basic charge corrections

Education Qualifications :

  • High school diploma or GED equivalent
  • Experience Qualifications :

  • Two (2) years of progressively responsible and directly related work experience
  • Required Knowledge, Skills and Abilities :

  • Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager
  • Can maintain professional communication with various PFS staff, payers, and patients regarding the billing of services.
  • Ability to follow oral and written instructions and interpret institutional and other policies accurately
  • Ability to communicate clearly and professionally both verbally and in writing
  • 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 accounts receivable software systems and medical billing operations
  • Familiarity with medical reimbursement policies and procedures and medical terminology
  • Knowledge of payer landscape, including Medicare, Medicaid, Workers' Compensation, Managed Care, or other Commercial insurance
  • These principles apply to ALL employees :

    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.

  • 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.

    Base Pay Scale : Generally starting at $33.89 - $38.15 per hour

    The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.

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    Patient Account Representative • Palo Alto, CA, US

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