Patient Account Representative

Lawall Prosthetics and Orthotics Services•Wilmington, DE

6d•Onsite

About The Position

We are seeking a detail-oriented and organized Patient Account Representative to join our Prosthetics and Orthotics (P&O) team. This position is responsible for the back-end processing of patient accounts, ensuring all documentation, insurance requirements, and billing paperwork are complete and accurate before patients can receive their devices and claims are submitted. The ideal candidate is highly organized, enjoys working behind the scenes, and has experience navigating insurance and medical documentation in a fast-paced healthcare environment.

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.
Proficient 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 is highly desirable and a Plus, but not necessary.
Knowledge of Medicare, Medicaid, and commercial insurance guidelines is a plus.
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 all 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 resolve deficiencies promptly.
Maintain accurate electronic patient records in compliance with HIPAA regulations.
Work closely 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.