Account Representative I

Job Description

Verifies patient insurance coverage. Ensures accurate billing codes. Submits claims to insurance payers. Follows up on denied claims. Resolves billing discrepancies. Communicates with insurance companies to clarify coverage details. Updates patient accounts. Maintains compliance with billing regulations. Assists patients with understanding their insurance benefits and payment responsibilities. Understands managed care payment methodologies and principles. Interprets payment methodologies for various payer types. Receives and documents correspondence from auditing bodies.

Knowledge, Skills, And Abilities

• Able to work with advanced billing procedures
• Knowledge of the Revenue Cycle and the links between departments: Charge Capture, Consumer Access, HIM, Coding, and Patient Financial Services
• Working knowledge involving coverage, payment, compliance, and basic billing rules for Government and Managed Care payers
• Uses discretion when discussing personnel/patient related issues that are confidential in nature
• Ability to give and follow written and verbal directions
• Self‐motivator, quick thinker, communicates professionally and effectively in English, both verbally and in writing
• Ability to work with all departments and all levels of management
• Basic understanding of an explanation of benefits (EOB)
• Basic knowledge of CPT, ICD-10, and HCPCS coding standards
• Strong organizational skills
• Strong keyboard and 10 key skills
• Proficiency in Microsoft Suite applications, specifically Excel and Word applications, as well as Outlook
• Ability to communicate effectively in written and oral form with diverse populations
• Interpersonal skills to promote teamwork
• Ability to multitask and function in a fast‐paced environment
• Ability to prioritize and problem‐solve
• Comfort with interpreting payer contractual language
• Ability to navigate payer website/portals to perform remittance research and gather additional information needs

Education

High School Grad or Equiv

Schedule

Monday-Friday 8 am – 4:30 pm , Onsite-flexible