Job Summary

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.

Duties and Responsibilities

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.

Job Requirements

• High school diploma or GED required; associate degree in healthcare administration or a 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.
• Required proficiency with Athena Collector, including payment posting, patient refunds processing, patient AR workflows, statements, reporting, and portal features.
• Bilingual in English and Spanish is required, with the ability to communicate clearly and professionally with patients in both languages.
• Proficiency with 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.

Physical Requirements

This position primarily performs administrative, analytical, reporting, and computer-based work in an office or remote-office environment. The role requires the ability to remain seated for extended periods, use a computer and phone, review detailed account information, communicate clearly, and complete routine office tasks.

Work Environment

Work is performed in a professional office, clinic, administrative, or approved remote-office setting. The position requires frequent computer use, regular communication through email, Teams, phone, billing systems, and reporting tools, and collaboration with billing, ancillary, branch, and operational stakeholders. The employee is expected to maintain professionalism, confidentiality, accuracy, and independent follow-through while supporting team workflows and leadership reporting needs.

Physical Demands

• Prolonged periods of sitting at a desk and working on a computer.
• Frequent use of hands and fingers for typing, operating office equipment, and using technology systems.
• Ability to communicate effectively, including speaking, hearing, and exchanging information in person, virtually, and via phone.
• Occasional standing, walking, bending, or reaching within office or clinical environments.
• Ability to lift and carry light items, typically up to 15-25 pounds, such as laptops, documents, reports, or office materials.

This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position. 

Responsibilities may be modified, assigned, or adjusted based on business needs. Employees may be asked to perform other job-related

Duties as assigned to support departmental and organizational objectives.