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Piedmont Healthcare Inc.

Patient Account Rep III

Posted a day ago
2-5 years experience
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AI Summary

Resolve complex claims, denials, and payer escalations while applying advanced knowledge of payer rules and regulatory requirements and maintaining audit-ready documentation. Serve as a subject matter expert, support training and quality initiatives, and partner with leadership to improve processes and payer performance.

Responsibilities

This position serves as a senior specialist responsible for resolving the most complex claim issues, denials, and payer escalations. This role requires advanced knowledge of payer rules, regulatory requirements, and audit ready documentation. Representative III acts as a subject matter expert, supports training and quality initiatives, and partners with leadership to improve processes and payer performance.

Qualifications

Education
  • H.S. Diploma or General Education Degree (GED) Required
Work Experience
  • 3 years of progressively responsible experience in hospital billing, follow up, denial management, or related revenue cycle functions. Required
  • Experience with complex payer types (Medicare Advantage, Medicaid Managed Care, Workers’ Compensation, TPL, MSP). Preferred
  • Advanced Epic proficiency. Preferred
  • Experience supporting training, quality review, or process improvement. Preferred

Business Unit : Company Name

Piedmont Healthcare Corporate

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