Valley Medical Center
Patient Account Representative (2025-1378)
Valley Medical Center, Renton, Washington, United States, 98056
Job Details
Job Title: Patient Account Representative (2025-1378)
Location: Billing Office, Renton, WA
Department: Patient Financial Services
Shift: Days
Type: Full Time
Hours: 8:00 AM to 5:00 PM, Monday – Friday or assigned.
Salary Range: Min $24.92 – Max $41.65/hrly, DOE.
Job Description This position is responsible for performing a variety of complex duties in support of reimbursement from the patient liability and insurance carriers for both hospital and professional claim adjudication. As a Patient Account Representative, you will be a guiding force behind efficient patient billing and account management. Your responsibilities will span the entire account lifecycle – from processing claims and collecting payments to resolving issues and addressing patient inquiries with empathy and clarity. position requires substantial knowledge and execution of third‑party payer policies, experience in patient liability management, collections, and communication proficiency.
Prerequisites
Associate (2‑year) degree required or equivalent experience; college (4‑year) degree preferred.
Minimum three years of equivalent work experience in a hospital, medical office/clinic business office, or insurance company, with billing and collections experience.
Comprehensive working knowledge of third‑party insurance processes, patient collection processing, complex remittance processing, and excellent customer service skills.
Demonstrated knowledge of medical terminology and abbreviations.
Demonstrated knowledge of Microsoft Word, Excel, and Outlook.
Qualifications
Prior Epic Resolute Hospital and Professional experience preferred.
Excellent organizational and time‑management skills.
Excellent written and verbal communication skills.
Intermediate technical skills including PC and MS Outlook.
Advanced knowledge of Explanation of Benefits (EOB) for both the UB‑04 for Hospital Billing and HCFA 1500 for Professional Billing.
Advanced knowledge of insurance billing, collections, and insurance terminology.
Extensive knowledge of third‑party reimbursements from commercial insurance companies, government payers, and other third‑party specialty payers.
Flexible, adaptable, and can effectively cope with change.
Demonstrates effective communication and interpersonal skills with a diverse population.
Demonstrates the ability to communicate with tact, poise, courtesy, respect, and compassion.
Able to prioritize tasks, carry out assignments independently and within a team, and practice good judgment.
Demonstrate a commitment to the organizational values by displaying a professional attitude and appropriate conduct in all situations.
Performance Responsibilities
Maintain knowledge of payer requirements under Valley Medical Center's Corporate Compliance program.
Familiar with VMC Patient Accounts payment policies and procedures, including VMC financial assistance programs.
Provide suggestions for process or quality improvement opportunities.
Request financial assistance adjustments, administrative adjustments, and contractual allowance corrections per policy.
Work with patients on options for self‑pay account balances, payment arrangements, and refer to financial counselor as appropriate.
Receive inbound and make outbound calls to resolve questions from patients, families, insurance companies, attorneys, or other entities.
Accurately and timely bill UB/HCFA claims for all insurance/government payors, including primary, secondary, and tertiary billing.
Understand and adhere to all federal, state, and local payer‑billing requirements.
Utilize payer/provider instruction manuals and hospital policies to submit "clean" claims.
Review payer rejections (837 transaction sets), UB and 1500 claim forms rejected by the electronic billing system; correct errors and release for transmission.
Review Explanation of Benefits (EOBs) and vouchers to pursue payment of claims.
Edit patient insurance information on accounts per Insurance Carrier Change Policy and Procedure.
Contact insurance companies/third parties, patients, physicians, and departmental staff to obtain necessary information and collect outstanding payments.
Follow up with appropriate payer for claims status, identify, analyze, and resolve payment barriers.
Correct data in payer systems such as Medicare and Medicaid; research and resolve under‑paid claims; research and appeal denied claims.
Take patient payments by phone or in person.
Explain policies and procedures to customers, solve problems independently and as part of a team.
Diligently reconcile cash daily to verify balance with daily bank deposit.
Process department deposits within 24 hours of receipt.
Maintain knowledge of current patient accounting systems functionality.
Coordinate non‑compliant or disputed denials with Clinical Audit & Appeals Manager.
Respond to requests for information, supporting documentation, and expedite payment on claims.
Escalate problem accounts to Manager when appropriate.
Perform all job functions consistently with Valley's expectations (Valley Values).
Collaborate and promote an amicable working environment with key associates (HIM, Patient Access, Clinic Network, Hospital Departments).
Maintain confidentiality of all protected health information.
Return all phone calls within 24 hours of receipt.
Adhere to policies and procedures as required by VMC.
Participate in and attend meetings and training as required.
Maintain regular and punctual attendance.
Notify PFS Director and Manager when new insurance regulations are identified.
Complete documentation of daily activities for productivity tracking and patient account volume management.
Perform other related job duties as required.
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Location: Billing Office, Renton, WA
Department: Patient Financial Services
Shift: Days
Type: Full Time
Hours: 8:00 AM to 5:00 PM, Monday – Friday or assigned.
Salary Range: Min $24.92 – Max $41.65/hrly, DOE.
Job Description This position is responsible for performing a variety of complex duties in support of reimbursement from the patient liability and insurance carriers for both hospital and professional claim adjudication. As a Patient Account Representative, you will be a guiding force behind efficient patient billing and account management. Your responsibilities will span the entire account lifecycle – from processing claims and collecting payments to resolving issues and addressing patient inquiries with empathy and clarity. position requires substantial knowledge and execution of third‑party payer policies, experience in patient liability management, collections, and communication proficiency.
Prerequisites
Associate (2‑year) degree required or equivalent experience; college (4‑year) degree preferred.
Minimum three years of equivalent work experience in a hospital, medical office/clinic business office, or insurance company, with billing and collections experience.
Comprehensive working knowledge of third‑party insurance processes, patient collection processing, complex remittance processing, and excellent customer service skills.
Demonstrated knowledge of medical terminology and abbreviations.
Demonstrated knowledge of Microsoft Word, Excel, and Outlook.
Qualifications
Prior Epic Resolute Hospital and Professional experience preferred.
Excellent organizational and time‑management skills.
Excellent written and verbal communication skills.
Intermediate technical skills including PC and MS Outlook.
Advanced knowledge of Explanation of Benefits (EOB) for both the UB‑04 for Hospital Billing and HCFA 1500 for Professional Billing.
Advanced knowledge of insurance billing, collections, and insurance terminology.
Extensive knowledge of third‑party reimbursements from commercial insurance companies, government payers, and other third‑party specialty payers.
Flexible, adaptable, and can effectively cope with change.
Demonstrates effective communication and interpersonal skills with a diverse population.
Demonstrates the ability to communicate with tact, poise, courtesy, respect, and compassion.
Able to prioritize tasks, carry out assignments independently and within a team, and practice good judgment.
Demonstrate a commitment to the organizational values by displaying a professional attitude and appropriate conduct in all situations.
Performance Responsibilities
Maintain knowledge of payer requirements under Valley Medical Center's Corporate Compliance program.
Familiar with VMC Patient Accounts payment policies and procedures, including VMC financial assistance programs.
Provide suggestions for process or quality improvement opportunities.
Request financial assistance adjustments, administrative adjustments, and contractual allowance corrections per policy.
Work with patients on options for self‑pay account balances, payment arrangements, and refer to financial counselor as appropriate.
Receive inbound and make outbound calls to resolve questions from patients, families, insurance companies, attorneys, or other entities.
Accurately and timely bill UB/HCFA claims for all insurance/government payors, including primary, secondary, and tertiary billing.
Understand and adhere to all federal, state, and local payer‑billing requirements.
Utilize payer/provider instruction manuals and hospital policies to submit "clean" claims.
Review payer rejections (837 transaction sets), UB and 1500 claim forms rejected by the electronic billing system; correct errors and release for transmission.
Review Explanation of Benefits (EOBs) and vouchers to pursue payment of claims.
Edit patient insurance information on accounts per Insurance Carrier Change Policy and Procedure.
Contact insurance companies/third parties, patients, physicians, and departmental staff to obtain necessary information and collect outstanding payments.
Follow up with appropriate payer for claims status, identify, analyze, and resolve payment barriers.
Correct data in payer systems such as Medicare and Medicaid; research and resolve under‑paid claims; research and appeal denied claims.
Take patient payments by phone or in person.
Explain policies and procedures to customers, solve problems independently and as part of a team.
Diligently reconcile cash daily to verify balance with daily bank deposit.
Process department deposits within 24 hours of receipt.
Maintain knowledge of current patient accounting systems functionality.
Coordinate non‑compliant or disputed denials with Clinical Audit & Appeals Manager.
Respond to requests for information, supporting documentation, and expedite payment on claims.
Escalate problem accounts to Manager when appropriate.
Perform all job functions consistently with Valley's expectations (Valley Values).
Collaborate and promote an amicable working environment with key associates (HIM, Patient Access, Clinic Network, Hospital Departments).
Maintain confidentiality of all protected health information.
Return all phone calls within 24 hours of receipt.
Adhere to policies and procedures as required by VMC.
Participate in and attend meetings and training as required.
Maintain regular and punctual attendance.
Notify PFS Director and Manager when new insurance regulations are identified.
Complete documentation of daily activities for productivity tracking and patient account volume management.
Perform other related job duties as required.
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