Job Description

The Patient Accounts Receivable & Support Specialist is responsible for responding to patient phone calls and electronic portal inquiries related to billing, balances, refunds, and account questions. This role provides frontline patient financial support through routine account review, documentation, and follow up while adhering to established policies and procedures. Complex issues are escalated as appropriate.

Account & Service Management

• Serve as the first point of contact for patient phone calls and patient portal messages related to billing, balances, payments, refunds, and general account questions.
• Respond to inquiries in a timely, professional, and compassionate manner, following established service standards.
• Document all patient interactions, actions taken, and next steps clearly and accurately in the billing system and case management tools.
• Route or escalate issues that fall outside established guidelines.

Patient Accounts & AR Support

• Respond to patient inquiries related to balances, payments, refunds, and billing statements in a professional and compassionate manner.
• Review patient accounts to identify self-pay balances, unapplied payments, credit balances, and refund eligibility.
• Assist patients with understanding payment options, payment plans, and next steps for resolving outstanding balances.
• Perform routine follow up on patient AR accounts to support timely resolution.
• Ensure accurate application of payments, adjustments, and insurance determinations.
• Identify discrepancies or incomplete information and route accounts appropriately for further review or escalation.

Refund Processing

• Prepare and process patient refunds in accordance with internal policies and regulatory requirements.
• Verify refund eligibility, payment sources, and required documentation.
• Maintain accurate records and documentation to support audit requirements.
• Respond to patient questions regarding refund status and timelines.

Insurance & Claim Support

• Assist patients with understanding insurance determinations, explanations of benefits (EOBs), and patient responsibility.
• Provide general guidance on next steps, including contacting the insurance carrier or submitting additional information.
• Route insurance related issues to the appropriate department when additional payer follow up is required.

Cross Functional Support

• Communicate with clinics, revenue cycle, and ancillary teams to resolve routine account questions.
• Follow established workflows to ensure timely and accurate handoffs.
• Support assigned call queues, work queues, and coverage needs.

Compliance & Documentation

• Adhere to all organizational policies related to HIPAA, PHI protection, and data security.
• Ensure all account actions, adjustments, and refund activity are documented accurately and completely.
• Follow established procedures and escalate issues that fall outside defined guidelines.

Requirements

• High school diploma or GED required, associate’s degree in healthcare administration, or related field preferred.
• 2–4 years of experience in patient accounts receivable, billing, refunds, or patient financial services preferred.
• Experience in a medical group or multisite healthcare environment is a plus.
• Basic understanding of medical billing, patient AR, and healthcare revenue cycle processes.
• Proficiency with billing systems (e.g., Athena Collector), Microsoft Office, and case management tools.
• Strong customer service and communication skills, both verbal and written.
• Ability to follow detailed procedures and maintain accuracy in a high volume environment.
• Strong organizational skills with attention to detail.
• Ability to perform transactional, repetitive work accurately in a high volume environment.
• Ability to prioritize assigned tasks and meet productivity and quality standards.
• Works under regular supervision and within defined guidelines and procedures.