Patient Account Representative-Insurance

Job Responsibilities

• Reviews insurance claims prior to submission to identify and resolve errors, ensuring accurate and timely billing in accordance with payer guidelines.
• Maintains current knowledge of payer guidelines, updates, payer websites and payer portals.
• Supports development and implementation of department procedures and workflows.
• Participates actively in department meetings, focus groups, training opportunities, and process improvement initiatives.
• Performs other duties as assigned.

Qualifications

• College Certificate, Associate’s Degree, or equivalent related experience required.
• Experience in medical billing, patient accounts, or healthcare revenue cycle operations preferred.
• Knowledge of insurance payers, billing processes, claim submission, and reimbursement workflows.
• Experience with claim follow-up, denial management, and appeals preferred.
• Strong attention to detail and effective problem-solving skills.
• Proficiency with computers with the ability to learn billing systems, software, and navigate payer websites and portals.
• Effective communication to interact with insurance companies, internal departments, team members and patients.
• Strong math skills with a basic understanding of the revenue cycle.
• Understanding of Provider Based Billing (PBB) preferred.
• Able to manage multiple tasks independently and as part of a team in a fast-paced environment.