RCM Call Center Representative – Patient Accounts & Collections

 The Call Center Representative – Patient Accounts & Collections is responsible for managing all aspects of patient accounts receivable (A/R) related to self-pay balances. This role handles inbound and outbound patient calls, collections, payment plans, refunds, and follow-up on clinic-identified balance inquiries. The representative reviews patient accounts within the Practice Management (PM) system, interprets Explanation of Benefits (EOBs), and applies knowledge of major payor policies to accurately explain balances and resolve patient concerns. The position plays a critical role in maintaining patient satisfaction while ensuring timely and compliant collections.  

Key Responsibilities 

Patient Account & Collections Management 

• Manage assigned patient A/R accounts, including follow-up on outstanding self-pay balances. 
• Conduct inbound and outbound calls to patients regarding balances, statements, payment options, and account resolution. 
• Collect payments via approved payment methods and accurately post transactions in the PM system. 
• Set up, maintain, and monitor compliant payment plans according to organizational policy. 
• Process and follow up on patient refunds as needed. 
• Perform follow-up on clinic requests related to patient balances, billing questions, or account corrections. 

Account Review & Billing Accuracy 

• Review patient accounts in the PM system to ensure accuracy of charges, payments, adjustments, and insurance processing. 
• Read and interpret EOBs to explain insurance determinations, denials, patient responsibility, and payor adjustments. 
• Apply knowledge of major payor policies (commercial, Medicare, Medicaid) when addressing patient inquiries. 
• Identify billing discrepancies and escalate issues appropriately for resolution. 

Patient Communication & Service 

• Provide clear, empathetic, and professional communication to patients regarding sensitive financial matters. 
• Educate patients on billing statements, insurance processing timelines, and financial responsibility. 
• Handle escalated or complex patient inquiries related to balance or insurance explanations. 
• Maintain detailed and accurate account notes documenting all patient interactions and actions taken. 

Compliance & Quality 

• Ensure all collection activities comply with federal and state regulations (including FDCPA where applicable), organizational policies, and Financial Assistance Program (FAP) guidelines. 
• Follow call handling, scripting, and documentation standards to ensure consistency and quality. 
• Protect patient confidentiality and adhere to HIPAA requirements at all times. 

Productivity & Performance 

• Meet or exceed individual performance goals related to call volume, collections, payment plans, and account resolution. 
• Participate in quality reviews, coaching, and ongoing training. 
• Collaborate with team members and supervisors to support workflow efficiency and service level goals. 
• Other duties as assigned. 

Qualifications 

Required 

• High school diploma or equivalent. 
• Minimum of 1–2 years of experience in healthcare billing, patient collections, or medical call center environment. 
• Experience working patient A/R and self-pay balances. 
• Ability to read and understand EOBs and patient billing statements. 
• Working knowledge of major payor types and basic payor policies. 
• Experience using a Practice Management (PM) system. 
• Strong verbal communication, customer service, and conflict-resolution skills. 
• Reliable high-speed broadband internet connection required for remote work.  

Preferred 

• Experience in a multi-specialty or clinic-based healthcare setting. 
• Knowledge of Financial Assistance Programs (FAP) and payment plan compliance. 
• Prior experience handling refunds and account adjustments. 
• Experience with RingCentral (VoIP) and Allscripts (PM/EHR) systems is strongly preferred. 
• Proficiency with Microsoft Office tools (Outlook, Word, Excel, Teams) preferred. 

Skills & Competencies 

• Strong attention to detail and accuracy 
• Empathetic and professional communication style 
• Ability to explain complex billing and insurance concepts in simple terms 
• Time management and ability to prioritize workload 
• Comfort handling sensitive financial conversations 
• Proficiency with call center systems and Microsoft Office applications 

Key Physical & Mental Requirements:

• Ability to lift up to 50 pounds.
• Ability to push or pull heavy objects using up to 50 pounds of force.
• Ability to sit or stand for extended periods during training sessions or on-site support.
• Ability to use fine motor skills to operate office equipment and/or machinery.
• Ability to receive and comprehend instructions verbally and/or in writing.
• Ability to apply logical reasoning for simple and complex problem-solving.
• Ability to travel to multiple locations as required to support business needs.

What We Offer

• Competitive salary and benefits package, including health insurance, retirement plans, paid time off, and professional development opportunities.
• A collaborative and inclusive work culture focused on employee well-being.
• Opportunities for advancement within the Revenue Cycle Management department.
• Comprehensive training program to ensure success in the role.

Southeast Primary Care Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected class.

How to Apply

Interested candidates should submit a resume and cover letter to https://mysemg.com/careers. Applications will be reviewed on a rolling basis. We thank all applicants for their interest; however, only those selected for an interview will be contacted.