Pay Range:
The base pay range for this position is
$21.82-$39.52 Hourly
however, base pay offered may vary depending on job-related knowledge, skills, and experience.
Job Title: Patient Account Representative II
Department: Patient Financial Services
Reports to: Director of Patient Financial Services
Classification: Hourly
Position Overview:
We are seeking a detail-oriented and experienced Patient Account Representative II to join our team. The ideal candidate will possess a strong understanding of Revenue Cycle Management processes, with specific expertise in handling denials and appeals.
Required Education, Licensure, Certifications, & Experience:
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High school diploma or equivalent.
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6 years of current experience in claims processing and denials management.
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3 years of current EPIC experience required
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Recent experience working with EPIC EMR system.
Preferred Education, Certifications, & Experience:
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Bachelor’s degree.
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CPC, CRCR, or CPMA certifications.
Essential Functions:
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Analyze denials and determine the appropriate course of action for appeal or resubmission.
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Prepare and submit appeals for denied claims, ensuring accuracy and compliance with regulatory requirements.
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Collaborate with internal teams, including billing, coding, and clinical staff, to gather necessary information for appeals and resolve denial issues efficiently.
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Maintain detailed records of denial cases, including appeals filed, communications with insurance representatives, and any additional documentation required.
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Monitor the status of appealed claims and follow up with insurance representatives as needed to expedite resolution.
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Generate and analyze reports on denials trends, identify root causes, and make recommendations for process improvements.
Non-Essential Functions:
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Any other duties as needed to drive towards the vision, fulfil the mission, and abide by the values of the organization.
Required Skills:
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Ability to analyze denial reasons, identify trends, and develop strategies for minimizing denials.
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Excellent written and verbal communication skills, with the ability to effectively communicate with internal staff and insurance representatives.
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Strong attention to detail and accuracy in documentation and appeals submissions.
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Ability to collaborate effectively with multidisciplinary teams to achieve common goals.
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Thorough understanding of billing regulations, coverage guidelines, and appeals process.
Physical Requirements:
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Sitting: 90%. Standing/Walking: 10%
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Occasional lifting/carrying of supplies and paper weighing up to 40 pounds.
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Occasional pushing/pulling to move supplies and equipment.
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Occasional climbing of stairs to reach other levels of the building.
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Occasional stooping/kneeling/bending/crouching to file in low cabinets, purge old bills and to print forms.
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Occasional reaching/handling/fingering to complete paperwork, use computers, file, and answer telephones.
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Frequent talking/hearing/seeing to interact with staff and customers to complete assigned tasks.
Environmental Conditions: Inside
Location: Onsite or Remote
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Occasional exposure to noise from printers, telephones and fax machines.
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Minimal risk of injury due to proximity of moving parts on computer printer, typewriter, and copier.
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Minimal exposure to fumes and caustic materials from copy machine toner and cleaning supplies.
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Minimal exposure to biohazardous materials.
Travel Requirements:
If not in the Palouse area, will need to travel to Pullman for New Employee Orientation week
Company Perks:
Our employees are our most important asset and that’s reflected in our benefits. Pullman Regional is proud to offer a variety of benefits to support employees and their families, including:
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Medical/Vision, Dental, Health Savings Account, and Paid Leave Time
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Employer Paid Life Insurance and Long-Term Disability
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Retirement with Employer Matching Contributions
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Voluntary Benefits that include: Life Insurance, Critical Illness, Accident Insurance, and Short-Term Disability
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Services Discount and EAP Resources
A Few More Important Points:
The job posting highlights the most critical responsibilities and requirements of the job. It is not all-inclusive. There may be additional duties, responsibilities, and qualifications for this job.
Disability Contacts:
Applicants with disabilities who require assistance or accommodation should contact Human Resources at
humanresources@pullmanregional.org
Current Pullman Regional Employees:
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