Job Purpose The Patient Account Representative is responsible for collections, account follow up, billing allowance posting for the accounts assigned to them. Duties and Responsibilities - Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites - Review and updates all patient and financial information accurately as given - Verify that information is accurate as to individual or insurance company responsible for payment of bill - Monitor all billings for accuracy, updating any that contain known errors - Monitor Medicaid/healthy options coupons to assure services are billed within expected timeframes - Bill all hospital services to primary insurer or patient correctly and within expected timeframe - Follow up with insurance companies on all assigned accounts within expected timeframe - Explain hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contracts - Identify and report underpayments and denial trends - Analyze, identify and resolve issues causing payer payment delays; Initiate appeals when necessary - Manipulate excel spreadsheets and communicate results - Meet and maintain daily productivity and quality standards established in departmental policies - Act professionally, cooperatively and courteously with patients, insurance payors, co-workers, management and clients - Perform special projects and other duties as needed by the management team - Maintain confidentiality at all times - Other duties as assigned - Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards - Understand and comply with Information Security and HIPAA policies and procedures at all times - Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties Qualifications - High School Diploma or equivalent required - Medical Billing and Coding certification preferred, but not required - Experience in Hospital/Facility billing required - 2-3 years’ experience in insurance collections, including submitting and following up on claims required - Basic knowledge of healthcare claims processing including: ICD-9/10, CPT and HCPC codes, as well as UB-04 - Ability to use various workflow system and client host system such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accounts - Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies - Understanding of government, Medicare and Medicaid claims - Proficiency with Microsoft Office Suite including Excel and Word - Basic math and typing skills - Strong interpersonal skills, ability to communicate well at all levels of the organization - Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses - High level of integrity and dependability with a strong sense of urgency and results oriented  - Excellent written and verbal communication skills required - Gracious and welcoming personality for customer service interaction Working Conditions - Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes. - Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. - Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress. - Work Environment: The noise level in the work environment is usually minimal. Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

• Lead end-to-end servicing contact center operations across voice and digital channels. • Drive performance across key service metrics including service level, abandon rate, average handle time (AHT), first contact resolution (FCR), quality assurance (QA), customer satisfaction (CSAT), net promoter score (NPS), complaint management, and regulatory compliance. • Foster a strong coaching culture and build frontline leadership capability. • Drive demand management initiatives to reduce avoidable contacts. • Partner cross-functionally with Underwriting, Billing, Claims, Distribution, and Product teams to resolve systemic service issues. • Lead the enterprise QA framework including calibration standards and coaching effectiveness. • Integrate speech and text analytics to generate actionable insights. • Ensure governance, compliance, and performance transparency. • Oversee forecasting, capacity planning, scheduling, and intraday operations management. • Manage shrinkage controls and scenario planning. • Establish a unified workforce management model across internal and outsourced operations. • Provide operational ownership for contact center platforms including routing, IVR, call recording, and knowledge management tools. • Partner with IT to define technology roadmaps, integrations, and platform modernization initiatives. • Simplify and rationalize fragmented or legacy tooling. • Establish enterprise dashboards and KPI governance. • Lead Voice of the Customer (VOC) programs, root-cause analysis, and identification of contact demand drivers. • Translate insights into operational, training, and digital improvements. • Govern business process outsourcing (BPO) relationships, service level agreements (SLAs), and contract performance. • Ensure consistent performance management across internal and partner operations. • Lead the contact center transformation roadmap, including self-service capabilities, workflow automation, AI-assisted servicing, and digital enablement. • Develop business cases and oversee ROI realization for modernization initiatives. • Balance automation with regulatory compliance and customer trust considerations. • Own the enterprise Customer Experience function, establishing a cohesive customer-centric strategy aligned with corporate objectives. • Lead the development and improvement of end-to-end customer journeys across service, claims, and digital touchpoints. • Establish and govern Voice of the Customer programs, leveraging customer feedback, analytics, and operational insights to drive improvements. • Define and monitor enterprise CX metrics including NPS, CSAT, Customer Effort Score, and journey-level performance indicators. • Partner with leaders across operations, claims, marketing, digital, and HR to embed customer-centric behaviors, processes, and performance management across the organization. • Lead enterprise initiatives that strengthen customer-centric culture and improve brand perception and loyalty.

• Support end-user customers via email, chat, phone, and service management platforms in multiple languages • Resolve transaction issues, troubleshoot technical problems, and process online/offline refunds • Follow standard operating procedures and utilize knowledge base articles to resolve requests efficiently • Meet and exceed service level agreements with timely, accurate responses • Escalate complex issues to management when necessary • Maintain detailed case records and contribute to improving knowledge base documentation • Analyze customer issues to identify patterns and recommend solutions • Develop a deep understanding of products, services, and customer requirements

• Handle inbound customer calls professionally and efficiently • Understand customer concerns and provide accurate resolutions on the first call whenever possible • Clearly explain processes, product features, and next steps to customers • Maintain a calm, empathetic, and customer-focused tone at all times • Escalate complex or sensitive issues according to defined guidelines • Conduct approved outbound support calls for follow-ups and customer check-in calls • Represent Raenest positively as the first point of contact for customers • Accurately document all customer interactions in the CRM in real time • Handle customer data, transactions, and sensitive information with integrity and confidentiality