Patient Account Representative

Patient Account Representative

We are seeking a detail-oriented Patient Account Representative to join our team! In this role, you will be responsible for ensuring the accurate and efficient processing of billed services, including claims submission, payment and remittance entry, researching unpaid or denied claims, and following up on aged accounts receivable.

This is a full-time (1.0 FTE) position, working on-site at our Wausau office.

Essential Job Functions and Responsibilities

• Completes daily data entry of all incoming accounts receivable payments including personal payments, insurance payments, interest, medical records fees, and miscellaneous deposits.
• Posts electronic remittance advice (ERA) or explanation of benefits (EOB) to reflect accurate insurance payments, contractual adjustments, denials and recoupments.
• Performs daily electronic transmission of claims and patient statements. Verifies successful claims submission by reviewing clearinghouse reports for acceptance and / or rejection.
• Prints and mails paper claims with appropriate documentation.
• Researches all claim denials, provider level balances (PLB), offsets, recoupments, and incorrect payments or adjustments.
• Prepares patient or insurance refund paperwork for processing of credit balances within 60 days of discovery.
• Maintains daily cash flow chart, balances daily posting and insurance checks, and runs adding machine tape for deposit and prepares daily deposit for the bank.
• Researches monthly aged account receivable lists to assure that accounts receivable levels are within organization targets.
• Receives billing calls, answers questions, and assists patients with issues they may have regarding their accounts, and receives collection calls on delinquent accounts and arranges payment plans, or refers to financial counselor, if appropriate.
• Contacts insurance companies and other agencies regarding patient issues, benefits, or claim concerns.
• Maintains up-to-date knowledge of rules and regulations for medical billing. Maintains detailed and thorough knowledge of payer-specific laws and requirements to submit claims in a legal and compliant manner.
• Performs other duties as assigned.

Minimum Qualifications

High school diploma or equivalent required.

Advanced training / certification in medical billing, coding, and / or insurance preferred.

Minimum of one-year experience in a medical billing role is required, or equivalent education.

Competencies Required

Working knowledge of medical and insurance terminology.

Possesses interpersonal, communication, and listening skills necessary to deal effectively and courteously with patients and all staff members.

Ability to maintain strict confidentiality of fiscal and health information.