Account Representative

SPINE TEAM TEXAS MANAGEMENT COMPANY•Southlake, TX

4d•Onsite

About The Position

The Spine Team Texas Insurance Account Representative is responsible for resolving denied claims, researching and resolving patient accounts, and resolving both insurance and patient credits, including refunds, as well as maintaining working correspondence. As an AR Specialist, you will play a crucial role in optimizing revenue flow by effectively managing outstanding accounts receivable and ensuring timely reimbursement. The Account Representative Specialist reports directly to the Revenue Cycle Manager.

Requirements

High School diploma or equivalent is required.
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.

Nice To Haves

AAPC Certified Medical Coder a plus.

Responsibilities

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.
Maintain the highest level of customer service at all times.
Speak in a kind, courteous and professional manner when dealing with a patient/customer or co-worker.
Fulfill the Spine Team Texas mission of “Offering an Unparalleled Patient Experience!”
Exhibit a spirit of cooperation and positive attitude.
Maintain professionalism at all times.
Contribute positive interaction, promote value and be a “team-player” not only for their unit or department, but for Spine Team Texas as a whole.