Patient Account Representative – Medicare/Medicaid Exp

Med-Metrix

. Perform collections, account follow-up, and billing allowance posting for assigned accounts .

Posted 9/22/2026full-timeRemote • Virginia • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical billing and collections, with a strong understanding of healthcare claims processing, including ICD-9/10, CPT, and HCPC codes. Proficient in using workflow systems and maintaining compliance with HIPAA regulations while ensuring accuracy in billing and follow-up processes.

Highest-signal resume keywords

Medical Billing And Coding CertificationHospital/Facility Billing ExperienceInsurance Collections ExperienceICD-9/10, CPT, And HCPC Codes KnowledgeProficiency With Microsoft Office Suite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical BillingClaims ProcessingInsurance Follow-UpData AnalysisError CorrectionExcel Spreadsheet ManipulationHealthcare Reimbursement MethodologiesGovernment Claims UnderstandingBasic Math SkillsTyping Skills

Soft Skills

Interpersonal CommunicationWritten CommunicationVerbal CommunicationProblem-Solving SkillsSound Judgment

Tools & Technologies

STARSMSEAGLEEPICMicrosoft Office Suite

Certifications & Qualifications

Medical Billing And Coding Certification

Industry Keywords

HIPAA ComplianceMedicare ClaimsMedicaid ClaimsBilling Allowance PostingPayer Payment Delays

About the role

Key responsibilities & impact

Perform collections, account follow-up, and billing allowance posting for assigned accounts
Follow up with payers via phone, email, fax, or websites to resolve outstanding claims
Review and accurately update patient and financial information
Verify responsible parties and insurance payment information
Monitor billings for accuracy and correct errors
Monitor Medicaid/Healthy Options coupons to ensure services are billed within expected timeframes
Bill hospital services to primary insurers or patients correctly and on time
Explain hospital payment regulations and maintain knowledge of insurance regulations and hospital contracts
Identify and report underpayments and denial trends
Analyze and resolve issues causing payer payment delays and initiate appeals when necessary
Manipulate Excel spreadsheets and communicate results
Meet departmental productivity and quality standards
Maintain confidentiality and comply with HIPAA and information security policies
Limit access to protected health information to the minimum necessary
Perform other duties as assigned

Requirements

What you’ll need

High School Diploma or equivalent required
Medical Billing and Coding certification preferred, but not required
Experience in Hospital/Facility billing required
2-3 years’ experience in insurance collections, including submitting and following up on claims
Basic knowledge of healthcare claims processing including ICD-9/10, CPT and HCPC codes, and UB-04
Ability to use workflow and client host systems such as STAR, SMS, EAGLE and EPIC
Working knowledge of the insurance follow-up process and healthcare reimbursement methodologies
Understanding of government, Medicare and Medicaid claims
Basic math and typing skills
Proficiency with Microsoft Office Suite
Strong interpersonal, written, and verbal communication skills
Strong problem-solving and creative skills; ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability, with a strong sense of urgency and results orientation
Must possess a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes