Posted 23 days ago
Patient Billing Representative
AI Summary
Patient Billing Specialist handles payment processing, billing education, insurance verification, and claims inquiries in a remote role, delivering accurate and compliant service to patients.
About this role
Join us as a Patient Billing Specialist, where you’ll support patients with payment processing, billing education, insurance verification, and claims-related inquiries. This role delivers empathetic, accurate, and compliant service while navigating healthcare billing systems and policies. Agents perform all payment processing and payment plan functions in addition to advanced billing, insurance, and claims support.
Qualifications
- Customer service or call center experience required.
- Healthcare billing, insurance, or claims experience strongly preferred.
- Payment processing or financial transaction experience preferred.
- High school diploma or GED required; additional billing or healthcare education a plus.
- Technical proficiency with EMR systems and standard computer applications.
- Ability to work independently in a remote or virtual environment.
- Must be able to speak, read, write, and understand English.
- Background check required in accordance with applicable laws.
Essential Functions
These functions emphasize patient advocacy, analytical billing expertise, regulatory awareness, and high-quality service delivery.
Patient Payment & Account Support
- Accurately process patient payments via phone in accordance with Privia financial responsibility policies.
- Create, update, and maintain payment plans following established guidelines.
- Ensure transaction accuracy, proper documentation, and data integrity.
- Interpret and clearly explain claim notes, balances, and billing outcomes to patients.
- Verify, audit, and update insurance information for completeness and accuracy.
- Add or update insurance data within the EMR and resubmit pending or corrected claims.
- Educate patients on billing concepts including coordination of benefits, deductibles, coinsurance, copays, timely filing, and claim denials.
- Identify discrepancies and coordinate with internal teams to resolve billing-related issues.
- Research account history to determine the root cause of billing or payment concerns.
- Recommend appropriate resolutions and next steps in alignment with Privia policies.
- Maintain professionalism and empathy during complex or sensitive financial discussions.
- Utilize Privia-approved billing systems, EMR platforms, tools, and knowledge resources.
- Navigate multiple systems simultaneously while assisting patients.
- Adhere to all documentation, privacy, and security requirements.
- Maintain schedule adherence and consistent availability during assigned hours.
- Complete all required Privia and client-mandated training.
- Participate in ongoing uptraining and cross-training initiatives.
- Uphold HIPAA requirements, confidentiality standards, and Privia security protocols.
- Demonstrate professionalism, accountability, and patient-centered service in all interactions.
Billing, Insurance & Claims Support
Problem Resolution & Patient Education
Resource & System Utilization
Reliability & Continuous Learning
Ethical & Compliant Conduct
Requirements
- Strong verbal and written communication skills.
- Analytical problem-solving abilities and high attention to detail.
- Solid understanding of healthcare billing and insurance concepts.
- Ability to clearly explain complex billing information in patient-friendly language.
- Comfort working across multiple systems and tools simultaneously.
- Organized, self-motivated, and collaborative approach to work.
