Accounts Receivable Representative

Jax Spine & Pain Centers•Jacksonville, FL

4d•Onsite

About The Position

Jax Spine & Pain Centers is seeking a detail-oriented and motivated Accounts Receivable (AR) Representative to join our Revenue Cycle team. The AR Representative is responsible for managing insurance and patient accounts to ensure timely reimbursement of services rendered. This position performs claim follow-up, payment resolution, denial management, account reconciliation, and appeals while maintaining compliance with payer guidelines and Company policies. The ideal candidate is analytical, organized, and committed to maximizing collections while delivering exceptional customer service and supporting the overall financial health of the organization.

Requirements

High school diploma or equivalent.
Minimum of one (1) year of medical accounts receivable, medical billing, or revenue cycle experience.
Knowledge of medical insurance billing, claims processing, and reimbursement methodologies.
Experience working with commercial insurance, Medicare, Medicaid, and other third-party payers.
Strong analytical, organizational, and problem-solving skills.
Proficiency with Microsoft Office and electronic practice management systems.
Excellent written and verbal communication skills.

Nice To Haves

Experience in a pain management, ambulatory surgery center, orthopedic, or specialty medical practice.
Knowledge of CPT, ICD-10, and HCPCS coding principles.
Experience with electronic remittance advice (ERA), clearinghouses, and payer portals.
Certified Professional Biller (CPB), Certified Professional Coder (CPC), or other revenue cycle certification preferred.

Responsibilities

Review and manage assigned accounts receivable work queues to ensure timely reimbursement.
Follow up with commercial insurance carriers, government payers, and patients regarding outstanding balances.
Investigate, resolve, and appeal denied or underpaid claims.
Analyze Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to identify payment discrepancies.
Correct claim edits and billing errors to facilitate prompt payment.
Submit corrected claims, reconsiderations, and appeals within payer filing deadlines.
Research payer policies and reimbursement guidelines to resolve payment issues.
Document all account activity accurately within the practice management system.
Collaborate with Billing, Coding, Authorizations, Front Office, and Clinical teams to resolve claim issues and improve reimbursement.
Maintain productivity and quality standards while meeting departmental collection goals.
Assist with special projects and other revenue cycle duties as assigned.