Account Representative - Insurance Follow-up and Client Relations

Job Title: Account Representative - Level One
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. Ensures 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. Assists in identifying risk areas and preventing abuse and fraud.
3. Maintains confidentiality.
4. Works cooperatively with others.
5. Organizes work, sets priorities to meet deadlines, and adjusts as required.
6. Manages account receivable balances and contacts third-party payers to determine the reason for non-payment of claims.
7. Corrects errors and re-submits claims to receive payment.
8. Writes appeals for denials.
9. Conducts necessary follow-up in a timely manner until claims are paid or no further action can be taken.
10. Applies appropriate adjustments to claim outstanding balances.
11. Assists in determining which accounts are sent to collections.
12. Prepares patient refund request documentation.
13. Completes assigned tasks in a timely manner.
14. Updates patient demographic information when necessary.
15. Serves as a liaison between the client and third-party payers.
16. Completes detailed and accurate account notes for any work completed on the claim/account.
17. Prepares client reports based on client specifications.
18. Prepares patient statements.

Educational or Experience Requirements:
 High School Diploma
 One year of related experience
Skill Requirements:
 Demonstrated proficiency in the Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).
 Knowledge federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing for services.
 Excellent verbal and written communication skills.

Physical Requirements:
 Prolonged periods of sitting at a desk and working on a computer.