Patient Account Representative-Insurance

Olmsted Medical Center•Rochester, MN

2d•$23 - $29•Onsite

About The Position

This position is responsible for reviewing insurance claims prior to submission to identify and resolve errors, ensuring accurate and timely billing in accordance with payer guidelines. The role involves monitoring claim status, following up with insurance carriers on delayed or unpaid claims, and reviewing and resolving denied claims in collaboration with payers and patients. The Patient Account Representative will also post insurance payments, adjustments, and remittance activity accurately to patient accounts, investigate and resolve credit balances and billing discrepancies, and respond to internal and external inquiries related to billing and insurance. Documentation of all actions and follow-up activities within the billing system is crucial, as is maintaining current knowledge of payer guidelines, updates, websites, and portals. The role supports the development and implementation of department procedures and workflows, participates actively in department meetings and process improvement initiatives, and maintains data integrity within billing systems. Additionally, the position involves reviewing reports and work queues to support A/R goals and performing other duties as assigned.

Requirements

College Certificate, Associate’s Degree, or equivalent related experience required
Knowledge of insurance payers, billing processes, claim submission, and reimbursement workflows
Strong attention to detail and effective problem-solving skills
Proficiency with computers with the ability to learn billing systems, software, and navigate payer websites and portals
Effective communication to interact with insurance companies, internal departments, team members and patients
Strong math skills with a basic understanding of the revenue cycle
Ability to manage multiple tasks independently and as part of a team in a fast-paced environment

Nice To Haves

Experience in medical billing, patient accounts, or healthcare revenue cycle operations preferred
Experience with claim follow-up, denial management, and appeals preferred
Understanding of Provider Based Billing (PBB) preferred

Responsibilities

Reviews insurance claims prior to submission to identify and resolve errors, ensuring accurate and timely billing in accordance with payer guidelines.
Monitors claim status and follows up with insurance carriers on delayed or unpaid claims.
Reviews and resolves denied claims in collaboration with payers and patients.
Posts insurance payments, adjustments, and remittance activity accurately to patient accounts.
Investigates and resolves credit balances and billing discrepancies.
Responds to internal and external inquiries related to billing and insurance.
Documents all actions and follow-up activities within the billing system.
Maintains current knowledge of payer guidelines, updates, payer websites and payer portals.
Supports development and implementation of department procedures and workflows.
Participates actively in department meetings, focus groups, training opportunities, and process improvement initiatives.
Maintains data integrity within billing systems by following established workflows and standards.
Reviews reports and work queues to support A/R goals.
Performs other duties as assigned.