FLSA Class: Non-Exempt
Department: Revenue Cycle Management
Job Category: Administration
Reports to: AR Supervisor
Summary Description: The Account Representative is responsible for accounts receivable (AR) follow-up within client-focused revenue cycle operations while demonstrating and executing in depth knowledge of all standard operating procedures communicating issues, trends, concerns and suggestions to leadership.
Essential Functions: To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Review outstanding insurance balances to identify and resolve issues preventing finalization of
claim payment; including coordinating with payers, patients and clients when appropriate.
- Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR.
- Review credit balances and validate reimbursement requests and initiate reallocation or refunds when appropriate.
- Maintain in-depth working knowledge of the various applications associated with the workflows.
- Ensure all workflow items are completed within the set turn-around-time within quality expectations.
- Utilize functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information.
- Attend required meetings and participates in training programs as required.
- Understand and adhere to HIPAA policies, procedures and regulations to ensure and maintain patient confidentiality.
- Contributes to team effort by accomplishing related results as needed.
- Perform other duties as assigned.
- Bachelor's degree from a four-year college or university; or two years related experience and/or
training; or equivalent combination of education and experience in healthcare required.
- Coding and billing certification preferred.
- Ability to handle high volume and stressful situations in a calm and professional manner.
- Has the ability to set priorities and work independently while maintaining a high degree of accuracy.
- Possess a strong work ethic and a high level of professionalism with a commitment to client/patient satisfaction.
- Proficient in MS Office software; particularly Excel and Outlook.
- Athena, Allscripts, eClinicalWorks (eCW), and/or Centricity experience preferred
- Communications - Expresses ideas and thoughts verbally. Expresses ideas and thoughts in written form. Exhibits good listening and comprehension. Keeps others adequately informed. Selects and uses appropriate communication methods.
- Customer Service - Displays courtesy and sensitivity. Manages difficult or emotional customer situations. Meets commitments. Responds promptly to customer needs. Solicits customer feedback to improve service.
- Dependability - Responds to requests for service and assistance. Follows instructions, responds to management direction. Takes responsibility for own actions. Commits to doing the best job possible. Keeps commitments. Meets attendance and punctuality.
- Planning & Organization - Prioritizes and plans work activities. Uses time efficiently. Plans for additional resources. Integrates changes smoothly. Sets goals and objectives. Works in an organized manner.
- Quality - Demonstrates accuracy and thoroughness. Displays commitment to excellence. Looks for ways to improve and promote quality. Applies feedback to improve performance. Monitors own work to ensure quality.
- Use of Technology - Adapts to new technologies. Demonstrates required skills. Keeps technical skills up to date. Troubleshoots technological problems. Uses technology to increase productivity.
Work Environment: This job operates in a professional office environment. This role routinely uses
standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Work is typically indoors. The noise level in the work environment is usually moderate.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to sit; use hands to finger,
handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to
stand; walk; climb or balance and stoop, kneel, crouch, or crawl. The employee must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Travel: No travel is expected for this position.
Other Duties: This job description is not intended to cover or contain a comprehensive listing of activities, duties, standards or responsibilities that are required of the employee for this position. Duties, responsibilities and activities may change at any time with or without notice. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor.