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Patient Services Representative
Patient Services RepresentativePacer Group • Pomona, CA, United States
Patient Services Representative

Patient Services Representative

Pacer Group • Pomona, CA, United States
4 days ago
Job type
  • Full-time
Job description
Below mentioned is the job description for your reference:

Job Title: Patient Services Representative - Contract Billing (8537)

Location: 300 S. Park Ave, 6th Floor, Pomona, CA 91767
Job Duration: 13 Weeks / 3+ Months

Shifts:
  • 7:00 AM - 3:30 PM
  • 7:30 AM - 4:00 PM
  • 8:00 AM - 4:30 PM
  • 8:30 AM - 5:00 PM
Job Overview

The Patient Services Representative is responsible for managing hospital accounts receivable, conducting insurance follow-up, and ensuring accurate and timely reimbursement. This role requires strong knowledge of hospital billing processes, payer guidelines, and claim resolution procedures.

Responsibilities
  • Review hospital A/R aging reports and prioritize follow-up actions.
  • Conduct outbound calls to insurance carriers to collect outstanding balances and resolve claim-related issues.
  • Perform follow-up on institutional claims (UB-04).
  • Investigate, appeal, and resolve denied or underpaid claims to ensure maximum reimbursement.
  • Coordinate with internal departments-including billing-to address discrepancies and ensure claim accuracy.
  • Obtain insurance eligibility and benefits via web portals and payer customer service.
  • Document all collection and follow-up activities in the hospital system.
  • Ensure compliance with HIPAA, hospital policies, and all applicable federal and state regulations.
Qualifications
  • High school diploma or GED required.
  • 1-3 years of experience in hospital A/R, medical collections, or healthcare reimbursement.
  • Strong knowledge of hospital billing processes, CPT/ICD coding, and DRG reimbursement.
  • Familiarity with Medicare, Medi-Cal, and commercial payer guidelines.
  • Proficiency with hospital billing/follow-up systems and Microsoft Office applications.
  • Excellent communication skills for effective payer interaction.
  • Strong attention to detail with the ability to analyze denial reasons and payment variances.
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Patient Services Representative • Pomona, CA, United States

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