Job Description
Patient Services Representative, Revenue Cycle
Position Summary
This role is responsible for patient-facing billing support and account resolution activities in a high- volume urgent care environment. This role serves as a primary point of contact for patients regarding billing questions, balances owed, and account activity. This role ensures patient responsibility balances are accurate prior to billing, resolves escalated patient billing concerns, supports payment collection efforts, and reviews accounts for appropriate placement with third-party bad debt agencies. This role plays a key role in balancing strong patient experience with effective revenue collections.
Key Responsibilities
Patient Billing & Inquiry Resolution
Respond to inbound patient inquiries via phone, email, portal, or written correspondence regarding balances owed, billing statements, payments, and account activity.
Research patient accounts to provide clear, accurate explanations of charges, insurance processing, and patient responsibility.
Resolve routine patient billing questions independently and escalate complex issues as appropriate.
Outbound Patient Outreach & Collections
Contact patients to obtain missing information required for billing, such as insurance details or coordination of benefits.
Perform outbound calls to collect payment on outstanding patient balances in accordance with organizational policies and regulatory requirements.
Educate patients on payment options, payment plans, and financial policies.
Patient Responsibility Review & Accuracy
Review patient responsibility balances to confirm accuracy prior to statement generation or escalation.
Validate that insurance payments, contractual adjustments, and credits have been applied correctly before billing the patient.
Coordinate with Billing, Payments & Credits, and A/R Follow-Up teams to resolve discrepancies.
Bad Debt Review & Agency Placement Support
Review unresolved patient balances to confirm accounts meet established criteria for assignment to third-party bad debt agencies.
Ensure all required billing cycles, notifications, and documentation have been completed prior to placement.
Support accurate account placement, recalls, and reconciliation activities with external agencies.
Documentation, Compliance & Quality
Maintain detailed and accurate documentation of all patient interactions and account actions in the billing system.
Adhere to HIPAA, FDCPA (as applicable), state regulations, and organizational patient billing policies.
Meet established quality, productivity, and customer service standards.
Collaboration & Continuous Improvement
Collaborate with internal revenue cycle and clinic operations teams to resolve patient account issues efficiently.
Identify recurring patient billing concerns or workflow gaps and communicate improvement opportunities to leadership.
Required Qualifications
High school diploma or equivalent required; Associate degree preferred.
1–3 years of experience in healthcare patient billing, call center operations, or revenue cycle support.
Experience handling patient financial inquiries and resolving billing issues.
Strong customer service and communication skills, including de-escalation techniques.
Familiarity with California payer and patient billing and collections regulations.
Preferred Qualifications
Experience in urgent care or high-volume ambulatory healthcare settings.
Experience working with EHR/practice management and billing systems.
Certification such as CRCR or related revenue cycle credential (or progress toward certification).
Key Competencies
Patient-centered communication and empathy
Strong problem-solving and analytical skills
Attention to detail and documentation accuracy
Ability to manage high call volumes and account workloads
Professional judgment and escalation awareness
Working Conditions
Office or remote environment; flexibility for onsite work dictated by business needs