Accounts Receivable Representative

Eye Clinic of Wisconsin•Wausau, WI

1d•Onsite

About The Position

The Accounts Receivable Representative manages and resolves outstanding patient and insurance account balances to support timely reimbursement and accurate account resolution. The role works with insurance carriers, patients, providers, and internal departments to research billing issues, follow up on unpaid claims, process appropriate adjustments, and comply with clinic policies and regulatory requirements. The position is based at the main clinic at 800 N. First Street in Wausau, Wisconsin. Travel to satellite locations and communities served by the clinic is sometimes required. Work hours depend on clinic needs. The role involves sitting and/or standing for extended periods, with occasional lifting, bending, stooping, pushing, pulling, and stair climbing. Duties and requirements may evolve with clinic priorities, and additional duties may be assigned. Reasonable accommodations will be provided to qualified individuals with disabilities in accordance with applicable laws.

Requirements

High school diploma or equivalent required.
Proficiency with electronic medical record (EMR) and practice management systems.
Strong analytical and problem-solving skills.
Excellent communication and customer service abilities.
Strong attention to detail and organizational skills.
Ability to manage multiple priorities and meet productivity goals.
Proficiency with Microsoft Office applications, including Excel and Outlook.
Ability to maintain confidentiality and handle sensitive information appropriately.

Nice To Haves

Associate degree in healthcare administration, business, accounting, or a related field.
Experience in customer service, medical accounts receivable, medical billing, or revenue cycle.
Experience working with commercial insurance, Medicare, Medicaid, and other third-party payers.

Responsibilities

Communicate professionally and empathetically with patients about billing questions, insurance concerns, outstanding balances, and payment deadlines.
Maintain patient accounts in the billing system, generate invoices, collect and process payments, post receipts, and secure revenue while adhering to fair credit practices.
Review and scrub claims for proper coding and clean submission.
Review and follow up on outstanding insurance and patient accounts receivable.
Investigate and resolve denied, rejected, underpaid, or delayed insurance claims.
Contact insurance companies to obtain claim status and payment information and resolve discrepancies.
Submit corrected claims, appeals, and supporting documentation as needed.
Post account adjustments in accordance with clinic policies and contractual agreements.
Monitor aging reports and prioritize follow-up to reduce outstanding balances.
Review explanations of benefits and remittance advice to ensure accurate payment processing.
Identify billing trends and recurring issues and communicate findings to management.
Work with patients on account balances, payment arrangements, and billing questions.
Maintain accurate documentation of account activities and communications in the practice management system.
Collaborate with coding, billing, registration, and clinical staff to resolve claim and payment issues.
Ensure compliance with HIPAA, payer regulations, and clinic policies.
Assist with month-end reporting and special projects as assigned.
Obtain prior authorization from patients' insurance companies for upcoming procedures before the procedure date.
Perform other duties as assigned.