Job Role Description

Accounting > Patient Accounts Representative

Salary National Average

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Short Description:

A Patient Accounts Representative is responsible for managing patient billing, payments, and account inquiries to ensure accurate and timely financial transactions. They assist patients with understanding bills, insurance coverage, and payment options, and resolve account discrepancies or issues. The role involves maintaining detailed records, coordinating with billing and clinical teams, and ensuring compliance with healthcare regulations and organizational policies. Patient Accounts Representatives help optimize revenue cycle processes and support a positive patient experience. Strong communication, customer service, and attention-to-detail skills are essential for success in this role.

Duties / Responsibilities:

  • Manage patient billing accounts, including posting payments, generating statements, and reconciling balances
  • Verify patient insurance coverage, eligibility, and benefits prior to services or during claims processing
  • Review and resolve billing discrepancies, claim denials, and underpayments in collaboration with insurance providers and patients
  • Communicate with patients to explain charges, answer billing questions, and provide payment options
  • Prepare and submit accurate claims to insurance carriers, following coding and payer-specific guidelines
  • Maintain detailed records of account activity, patient interactions, and payment histories in electronic systems
  • Collaborate with healthcare providers, billing staff, and revenue cycle teams to ensure timely and accurate payments
  • Track aged accounts receivable and follow up on outstanding balances to reduce delinquencies
  • Generate reports on account status, collections, and payment trends for management review
  • Assist with training and guidance for new staff on billing procedures and patient account management

Skills / Requirements / Qualifications

  • Education: High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration, Accounting, or related field preferred
  • Experience: 1–3 years of experience in medical billing, patient accounts, or revenue cycle management
  • Technical Skills: Proficiency in medical billing software, EHR systems, and spreadsheet/reporting tools
  • Analytical Skills: Ability to review accounts, identify discrepancies, and resolve billing issues accurately
  • Attention to Detail: Accuracy in posting payments, documenting interactions, and submitting claims
  • Communication: Strong verbal and written skills for interacting with patients, insurance providers, and internal teams
  • Problem-Solving: Ability to investigate and resolve account issues, denials, and underpayments efficiently
  • Regulatory Knowledge: Understanding of HIPAA, insurance guidelines, and revenue cycle compliance

Job Zones

  • Title: Job Zone Three: Medium Preparation Needed.
  • Education: Most occupations in this zone require vocational school training, on-the-job experience, or an associate's degree.
  • Related Experience: Previous work-related skill, knowledge, or experience is required for these occupations. 
  • Job Training: Employees in these occupations usually need one or two years of on-the-job experience and informal training with experienced workers. A recognized apprenticeship program may be associated with these occupations.
  • Job Zone Examples: These occupations usually involve communication and organizational skills to coordinate, supervise, manage, or train others to accomplish goals. 
  • Specific Vocational Preparation in years: 1-2 years preparation (6.0 to < 7.0)

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