Account Representative

Overview

The Spine Team Texas Insurance Account Representative resolves denied claims, researches and resolves patient accounts, and handles insurance and patient credits, including refunds, while maintaining effective working correspondence. As an AR Specialist, you will optimize revenue flow by managing outstanding accounts receivable and ensuring timely reimbursement. The Account Representative Specialist reports to the Revenue Cycle Manager.

• Analyze and review outstanding claims, focusing on those with no response or denials. Identify and rectify errors, discrepancies, and missing information to resubmit claims promptly and accurately.
• Utilize knowledge of payor policies, medical coding guidelines, and billing regulations to appeal denials and secure correct reimbursement.
• Manage all incoming correspondence related to accounts receivable. Take necessary actions based on correspondence received, such as claim corrections, appeals, adjustments, or post-claim review medical records requests.
• Conduct thorough follow-ups on aging accounts receivable, prioritizing those with no response or denied claims. Utilize various communication channels to contact payers, patients, and other relevant parties to resolve outstanding balances and secure payment.
• Submit written appeals to carriers when applicable and ensure timely follow-up regarding status.
• Stay up to date with changes in payor policies and billing requirements. Ensure compliance with HIPAA, CMS, and other regulatory standards governing healthcare billing and reimbursement.

• High School diploma or equivalent is required.
• AAPC Certified Medical Coder a plus.
• Minimum of 3 years’ medical collections experience required, specifically in professional and institutional billing.
• Proficiency in medical billing software, Athena Practice, and electronic health record (EHR) systems.
• Strong knowledge of healthcare billing processes, medical terminology, CPT, ICD-10 coding, and billing regulations.
• Excellent analytical skills with the ability to identify patterns, trends, and discrepancies in claims.
• Ability to prioritize tasks, meet deadlines, and work efficiently in a fast-paced environment.

Must be able to sit for long periods of time in a well-lit, air-conditioned office environment. Must have ability to lift a minimum of 5 pounds. Must be able to work under pressure. Tasks involve no exposure to blood or other potentially infectious materials.

• High School diploma or equivalent is required.
• AAPC Certified Medical Coder a plus.
• Minimum of 3 years’ medical collections experience required, specifically in professional and institutional billing.
• Proficiency in medical billing software, Athena Practice, and electronic health record (EHR) systems.
• Strong knowledge of healthcare billing processes, medical terminology, CPT, ICD-10 coding, and billing regulations.
• Excellent analytical skills with the ability to identify patterns, trends, and discrepancies in claims.
• Ability to prioritize tasks, meet deadlines, and work efficiently in a fast-paced environment.

• Mid-Senior level

• Full-time

• Sales and Business Development
• Industries
• Medical Practices