Patient Account Representative

Lawall Prosthetics and Orthotics Services•Wilmington, DE

17d

About The Position

The Patient Account Representative is responsible for back-end processing of patient accounts for a prosthetics and orthotics team. The role ensures that documentation, insurance requirements, and billing paperwork are complete and accurate before patients receive their devices and claims are submitted. The ideal candidate is organized, detail-oriented, and experienced with insurance and medical documentation in a fast-paced healthcare environment. The representative reviews patient files, obtains required documentation, processes insurance authorizations, prepares billing materials, and follows up with physicians’ offices, patients, and insurers to resolve missing information. The position also maintains electronic patient records in compliance with HIPAA, collaborates with clinicians, front office staff, and billing personnel, and supports claim corrections, denials, and appeals by gathering documentation.

Requirements

High school diploma required.
Minimum of 1–2 years of experience in medical office administration, medical billing, insurance verification, or patient accounts preferred.
Strong attention to detail and organizational skills.
Excellent written and verbal communication skills.
Proficiency with electronic medical records (EMR) systems and Microsoft Office applications.
Ability to prioritize multiple tasks while meeting deadlines.
Commitment to maintaining patient confidentiality and HIPAA compliance.

Nice To Haves

Experience with prosthetics and orthotics, durable medical equipment (DME), or healthcare reimbursement.
Knowledge of Medicare, Medicaid, and commercial insurance guidelines.
Familiarity with medical terminology.
Experience working with insurance authorizations and documentation requirements.
Strong problem-solving and analytical skills.
Ability to work independently and collaboratively within a team.

Responsibilities

Review patient files for completeness and accuracy before claim submission.
Verify and obtain required documentation, including physician orders, clinical notes, and Letters of Medical Necessity (LMNs).
Process insurance authorizations and ensure payer-specific requirements are met.
Prepare and organize documentation for billing and reimbursement.
Follow up with physicians’ offices, patients, and insurance companies to obtain missing information.
Monitor outstanding documentation and promptly resolve deficiencies.
Maintain accurate electronic patient records in compliance with HIPAA regulations.
Work with clinicians, front office staff, and billing personnel to ensure timely processing of patient accounts.
Assist with claim corrections, denials, and appeals by gathering supporting documentation.
Perform other administrative duties as assigned.