Account Representative - Insurance Follow-up and Client Relations

Job Description

Job Title: Account Representative - Level One \t\t\t\t\t

Department: Account Representatives Department

Reports To: Manager

Job Summary:

The Account Representative is responsible for the direct management of assigned accounts through working the accounts receivable to obtain payment on outstanding balances, running client reports, creating patient statements, and communicating directly with the client(s).

Supervisory Responsibilities:

None

Essential Responsibilities:

1.\tEnsures compliance with established workflows, regulations, laws, ethics, compliance program, and contracting agreements related to billing by remaining up-to-date with requirements and established workflows.

2.\tAssists in identifying risk areas and preventing abuse and fraud.

3.\tMaintains confidentiality.

4.\tWorks cooperatively with others.

5.\tOrganizes work, sets priorities to meet deadlines, and adjusts as required.

6.\tManages account receivable balances and contacts third-party payers to determine the reason for non-payment of claims.

7.\tCorrects errors and re-submits claims to receive payment.

8.\tWrites appeals for denials.

9.\tConducts necessary follow-up in a timely manner until claims are paid or no further action can be taken.

10.\tApplies appropriate adjustments to claim outstanding balances.

11.\tAssists in determining which accounts are sent to collections.

12.\tPrepares patient refund request documentation.

13.\tCompletes assigned tasks in a timely manner.

14.\tUpdates patient demographic information when necessary.

15.\tServes as a liaison between the client and third-party payers.

16.\tCompletes detailed and accurate account notes for any work completed on the claim/account.

17.\tPrepares client reports based on client specifications.

18.\tPrepares patient statements.

Educational or Experience Requirements:

\tHigh School Diploma

\tOne year of related experience

Skill Requirements:

\tDemonstrated proficiency in the Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).

\tKnowledge federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for services.

\tExcellent verbal and written communication skills.

Physical Requirements:

\tProlonged periods of sitting at a desk and working on a computer.