Accounts Receivable, Billing, Billing Records, Claims Processing, Data Quality, Documentation, Federal Laws and Regulations, HIPAA (Health Insurance Portability and Accountability Act), Healthcare Administration, High School Diploma, Insurance, Insurance Claims, Insurance Documentation, Interpersonal Skills, Maintain Compliance, Medical Affairs, Medical Billing, Medical Record System, Microsoft Office, Multitasking, Patient Confidentiality, Patient Follow-up, Payment Processing, Reconciliation, Regulatory Compliance, Revenue Management, Sales Management, Security Compliance, Team Player, Telephone Skills, Time Management
Patient Account Specialist
The Patient Account Specialist will be responsible for managing various aspects of the medical administration billing process, including paper claim submission, patient account follow-up, Good Faith Estimates, claim documentation, patient communications, and patient payment processing.
This role is 100% on-site - Sacramento, CA (95811).
Essential Functions
- Prepare, review, and submit paper insurance claims accurately and timely.
- Generate and provide Good Faith Estimates in compliance with applicable regulations.
- Gather, organize, and submit required claim attachments and supporting documentation to insurance carriers.
- Process and distribute incoming and outgoing mail/correspondence related to billing, insurance, and patient accounts. Redirecting mail/correspondence to appropriate departments/personnel when necessary.
- Answer patient phone calls regarding billing inquiries, account balances, insurance claims, and payment options.
- Work patient accounts receivable (A/R) to resolve outstanding balances and follow up on unpaid claims and patient responsibility.
- Collect and process patient payments over the phone while maintaining confidentiality and compliance with payment security standards.
- Research and resolve billing discrepancies, denied claims, and payment issues.
- Maintain accurate documentation of all billing activities, patient communications, and account updates.
- Collaborate with clinical and administrative staff to ensure accurate billing information and claim submission.
- Additional duties as assigned by supervisor.
Minimum Requirements
- High School Diploma
- Knowledge of insurance claim processes, EOBs, and patient account management.
- Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
- Proficiency with electronic health records (EHR), practice management systems, and Microsoft Office applications is preferred.
Preferred Background
- Medical Billing or Healthcare Administration
- EPIC experience
- Previous experience in medical billing, revenue cycle management, or healthcare administration preferred.
- Experience working with paper claims and insurance follow-up is preferred.
- Knowledge of HIPAA compliance and patient confidentiality requirements.
- Ability to collaborate effectively across a broad spectrum of backgrounds and perspectives. Candidates who demonstrate inclusive thinking and interpersonal awareness help strengthen our commitment to equitable and compassionate care for all.
Reasonable Accommodations
One Community Health endorses and supports the Americans with Disabilities Act of 1990 (ADA) and the California Fair Employment and Housing Act (FEHA) and is committed to providing reasonable accommodations to qualified individuals with disabilities who are applicants or employees who need accommodations. If you require an accommodation due to a disability to complete this application or you are experiencing difficulty submitting your application, please contact us at OCHhumanresources@onecommunityhealth.com.
Our Benefits
For information on the comprehensive benefits we provide, please visit: https://onecommunityhealth.com/careers/recruitment/
Additional Information:
We only employ US citizens and non-US citizens authorized to work in the United States in compliance with federal law.