Account Representative - Patient Billing Specialist

General Summary:

This role involves managing the revenue cycle and general operations related to patient accounts. The ideal candidate will actively engage in delivering exceptional customer service and maintain respectful relationships with all stakeholders.

Essential Functions:

Responsibilities include preparing and facilitating monthly billing to all payors, including fiscal intermediaries, within timely filing deadlines. The role requires completing insurance verifications and authorizations as per program and insurance guidelines. You will transmit required data to vendors following CMS regulations, perform pre-billing audits, generate pre- and post-month-end reports, and reconcile accounts receivables with detailed reporting. Maintaining knowledge of patient rights and legal considerations in billing and collections is essential. Investigating and resolving outstanding claims, preparing journal entries, reviewing invoice coding, and conducting account analyses are also key duties. Additional support includes assisting with office tasks, clerical backup, report preparation, and data collection to support administrative and quality initiatives. Compliance with HIPAA privacy and security regulations regarding Protected Health Information (PHI) is mandatory.

Minimum Knowledge and Skills Required:

Familiarity with collection techniques and accounts receivable management is necessary. Basic understanding of Medicare, Medicaid, and commercial insurance is expected. Strong communication skills, proficiency with Microsoft Office (especially Excel), and calculator skills are important.

Preferred Knowledge and Skills:

Knowledge of accounting principles is advantageous.

Required Behavioral Skills:

Integrity, demonstrated by honesty and ethical conduct; compassion, shown through empathy and excellent customer service; accountability, with a proven ability to take ownership and adapt to changing priorities; respect, by collaborating effectively with diverse populations; and excellence, through strong communication, leadership, strategic thinking, and process improvement capabilities.

Minimum Education and Experience:

Prior experience in healthcare third-party coordination, preferably in home care, hospice, or similar settings, along with medical billing experience.

Preferred Education and Experience:

An associate degree in business with an emphasis on accounting, additional education in accounting, coding, or medical terminology, and relevant public accounting or medical billing experience.

Required Licenses/Certifications:

Valid driver's license and proof of auto liability insurance. This position serves a healthcare organization located in the Midwest region of the United States, offering competitive pay and a comprehensive benefits package.