Accounts Receivable Representative
Position Summary
The Accounts Receivable Representative is responsible for managing assigned insurance and patient accounts receivable to support timely and accurate reimbursement. This position performs account follow-up, researches and resolves billing discrepancies, works outstanding and denied claims, and communicates with insurance payers and patients regarding account balances.
Essential Functions
- Perform timely follow-up on outstanding insurance and patient accounts receivable.
- Review accounts for unpaid claims, denials, underpayments, and outstanding balances.
- Research and resolve billing and account discrepancies.
- Communicate with insurance payers regarding claim status, denials, payments, and outstanding balances.
- Work assigned billing and A/R work queues within established departmental timelines.
- Follow up on denied and unpaid claims and take appropriate action to resolve outstanding balances.
- Assist with patient account inquiries and resolve billing-related concerns.
- Maintain accurate and thorough documentation of account activity and follow-up.
- Research payer requirements and reimbursement guidelines as needed.
- Identify and communicate recurring billing or reimbursement issues to leadership.
- Maintain confidentiality when handling patient and financial information.
- Meet established productivity, quality, and departmental expectations.
- Perform other duties as assigned.
Qualifications
- High school diploma or GED required.
- Previous experience in accounts receivable, medical billing, collections, or healthcare revenue cycle preferred.
- Knowledge of healthcare billing and claims processing preferred.
- Familiarity with Medicare and Medicaid payer guidelines preferred.
- Knowledge of CPT, HCPCS, and diagnosis coding is a plus.
- Strong written and verbal communication skills.
- Strong attention to detail and organizational skills.
- Excellent problem-solving and critical-thinking abilities.
- Ability to manage multiple priorities and meet deadlines.
- Ability to work independently and as part of a team.
- Proficiency with computers and Microsoft Office applications.
Knowledge & Skills
- Healthcare revenue cycle and accounts receivable processes
- Insurance claims and payer follow-up
- Claims processing and billing systems
- Insurance reimbursement practices
- Account research and resolution
- Data collection and documentation
- Customer service and professional communication