Patient Account Representative

Job Description

Manages the preparation and submission of claims to insurance companies, ensuring accuracy and compliance.

• Works directly with physician practices and patients to process and secure payment for claims.
• Reviews and assists with appeals for unpaid and denied claims, collaborating with physician offices and the Central Billing Office.
• Solves tasks related to real-time eligibility (RTE) and claim denials to obtain payment.
• Verifies patients' insurance coverage through eligibility systems, patient contact, or insurance company calls.
• Aids offices with referrals and authorization processes to ensure timely and accurate submissions.
• Supports the Central Billing Office by obtaining copies of medical records as needed.
• Provides training and education to front office staff on eligibility, authorizations, tasks, claim edits, and denials.
• Offers software training related to front office duties and revenue cycle skills.
• Facilitates communication between offices and insurance companies to resolve billing issues.
• Ensures compliance with all relevant regulations and standards in billing and claims processing.

Knowledge, Skills, and Abilities

• Demonstrated effective communication and interpersonal relation skills
• Demonstrated computer experience using word processing and data entry software
• Must be able to type 40 wpm and know 10 key by touch
• Previous insurance billing experience
• Previous collections work experience in a physician office setting
• Strong understanding of bundling issues, modifiers, medical necessity guidelines and physician office billing
• Proficiency in Medical Terminology
• Solid understanding of all Federal and local regulations by payer
• Previous customer service work experience
• Problem Solving Skills and Attention to Detail

Education and Work Experience

• Associate [Preferred]
• High School Grad or Equiv [Required]
• Field Of Study N/A
• 1+ experience working in health care or completed a certificate or degree from a medical billing program [Required]
• Experience working with ICD-9, ICD-10 and CPT coding [Required]
• Insurance and A/R experience specific to eligibility, authorizations and claim denials [Required]
• Previous customer service work experience [Required]
• Electronic Health Record (EHR) experience [Preferred]

Physical Requirements

View physical requirements here

Pay Range

$16.63 - $26.60