Job Description

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