Patient Account Representative

Company Overview RMA Health is a leading provider of Revenue Cycle Management (RCM) solutions, dedicated to optimizing the financial performance of healthcare providers. Our comprehensive services include billing, coding, compliance, and consulting, all designed to streamline operations and maximize revenue. We are passionate about innovation, excellence, and delivering exceptional value to our clients. Position Summary The Patient Account Representative (PAR) is responsible for the timely and accurate resolution of insurance and patient accounts receivable for anesthesia services. This position performs comprehensive follow-up activities with commercial payers, government payers, patients, and third-party vendors to ensure appropriate reimbursement and account resolution. The ideal candidate possesses strong analytical and problem-solving skills, demonstrates persistence in resolving complex reimbursement issues, and maintains a thorough understanding of medical billing, insurance payment methodologies, and anesthesia-specific revenue cycle processes. Essential Duties and Responsibilities Accounts Receivable Management Perform daily follow-up on outstanding insurance claims and patient balances. Investigate and resolve unpaid, underpaid, denied, or rejected claims. Review accounts to identify root causes of reimbursement delays and implement corrective actions. Submit claim reconsiderations, appeals, corrected claims, and supporting documentation as appropriate. Monitor payer correspondence and respond to requests for additional information. Ensure timely resolution of accounts to minimize aging and maximize cash collections. Denial Management Analyze denial reasons and determine appropriate corrective actions. Research payer policies and contract provisions related to disputed claims. Escalate complex reimbursement issues to supervisory staff when necessary. Identify denial trends and communicate findings to leadership to support process improvement initiatives. Payment Integrity Support Review payments for accuracy and identify potential underpayments or processing errors. Assist with payment variance investigations and payer reimbursement reviews. Support recovery efforts for identified underpayments and payment discrepancies. Document findings and maintain detailed account notes. Enrollment and Administrative Support Assist with provider enrollment, credentialing, EFT, and ERA-related activities as assigned. Support maintenance of payer portal access and provider demographic updates. Coordinate with enrollment staff and payers to resolve routine enrollment-related issues. Clearinghouse and Claim Resolution Review and resolve clearinghouse claim rejections. Monitor claim submission activity and ensure successful transmission to payers. Research electronic claim issues and assist in correcting data or workflow deficiencies. Coordinate with clearinghouse vendors as directed. Patient Account Resolution Respond professionally to patient inquiries regarding account balances, insurance processing, and payment options. Assist patients with payment arrangements and account resolution. Maintain compliance with all applicable patient communication and privacy requirements. Documentation and Compliance Maintain complete and accurate account documentation. Follow established departmental workflows, policies, and productivity standards. Ensure compliance with HIPAA, payer requirements, and company policies. Participate in quality assurance and audit activities as assigned. Qualifications Education High school diploma or equivalent required. Associate's degree or relevant healthcare education preferred. Experience Minimum of 2 years of medical billing, accounts receivable, or healthcare revenue cycle experience required. Experience with anesthesia billing and reimbursement strongly preferred. Experience working commercial, Medicare, Medicaid, and managed care accounts preferred. Knowledge and Skills Understanding of medical billing, claims adjudication, and insurance reimbursement processes. Knowledge of explanation of benefits (EOBs), electronic remittance advices (ERAs), claim status inquiries, and payer portals. Strong analytical and problem-solving abilities. Excellent verbal and written communication skills. Ability to manage multiple priorities while maintaining attention to detail. Proficiency with Microsoft Office applications and medical billing systems. Ability to work independently and as part of a team. Performance Expectations Success in this role will be measured through: Timely resolution of assigned accounts receivable. Achievement of productivity and quality standards. Reduction of aged accounts and preventable denials. Effective management of payer follow-up activities. Accuracy of account documentation and work performed. Positive contributions to team performance and revenue cycle outcomes. Preferred Characteristics Persistent and resourceful problem solver. Strong sense of accountability and ownership. Professional and collaborative team member. Customer service oriented while maintaining focus on reimbursement objectives. Comfortable working in a fast-paced, metrics-driven environment. This position plays a critical role in ensuring the financial health of the organization by maximizing reimbursement, reducing aged accounts receivable, and supporting an efficient anesthesia revenue cycle operation.

Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Health insurance Health savings account Life insurance Paid time off Vision insurance

Education:

High school or equivalent (Required)

Experience:

medical billing, A/R, or healthcare revenue cycle : 2 years (Required) Ability to

Commute:

Morrisville, NC 27560 (Required)

Work Location:

Hybrid remote in Morrisville, NC 27560