Patient Billing Representative

These functions emphasize patient advocacy, analytical billing expertise, regulatory awareness, and high-quality service delivery.

Patient Payment & Account Support

• Accurately process patient payments via phone in accordance with Privia financial responsibility policies.
• Create, update, and maintain payment plans following established guidelines.
• Ensure transaction accuracy, proper documentation, and data integrity.

Billing, Insurance & Claims Support

• Interpret and clearly explain claim notes, balances, and billing outcomes to patients.
• Verify, audit, and update insurance information for completeness and accuracy.
• Add or update insurance data within the EMR and resubmit pending or corrected claims.
• Educate patients on billing concepts including coordination of benefits, deductibles, coinsurance, copays, timely filing, and claim denials.
• Identify discrepancies and coordinate with internal teams to resolve billing-related issues.

Problem Resolution & Patient Education

• Research account history to determine the root cause of billing or payment concerns.
• Recommend appropriate resolutions and next steps in alignment with Privia policies.
• Maintain professionalism and empathy during complex or sensitive financial discussions.

Resource & System Utilization

• Utilize Privia-approved billing systems, EMR platforms, tools, and knowledge resources.
• Navigate multiple systems simultaneously while assisting patients.
• Adhere to all documentation, privacy, and security requirements.

Reliability & Continuous Learning

• Maintain schedule adherence and consistent availability during assigned hours.
• Complete all required Privia and client-mandated training.
• Participate in ongoing uptraining and cross-training initiatives.

Ethical & Compliant Conduct

• Uphold HIPAA requirements, confidentiality standards, and Privia security protocols.
• Demonstrate professionalism, accountability, and patient-centered service in all interactions.

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• Strong verbal and written communication skills.
• Analytical problem-solving abilities and high attention to detail.
• Solid understanding of healthcare billing and insurance concepts.
• Ability to clearly explain complex billing information in patient-friendly language.
• Comfort working across multiple systems and tools simultaneously.
• Organized, self-motivated, and collaborative approach to work.