Patient Account Rep

Job Description

Job Description

Description:

At Barbour Orthopaedics , we’re dedicated to providing exceptional orthopedic care through advanced medical techniques, cutting-edge technology, and a patient-centered approach. As a trusted name in Orthopaedic medicine, we pride ourselves on our collaborative environment, commitment to excellence, and a shared mission to help patients live healthier, more active lives.

We're currently seeking an experienced Patient Account Representative to join our Revenue Team! If you’re looking to be part of a dynamic healthcare organization that values expertise, integrity, and a genuine dedication to patient care, we’d love to hear from you.

Key Responsibilities:

Accounts Receivable Management:

• Monitor and manage assigned insurance and patient accounts receivable work queues.
• Perform timely follow-up on unpaid, denied, and underpaid claims with insurance, work compensation, PIP carriers and patients.
• Research and resolve billing discrepancies, claim rejections, denials, and payment variances.
• Ensure accurate documentation of all account activity and follow-up actions within the billing system.

Claims & Payment Resolution:

• Review explanation of benefits (EOBs), electronic remittance advice (ERAs), and payer correspondence to determine appropriate actions.
• Submit corrected claims, appeals, reconsiderations, and supporting documentation as necessary.
• Identify trends in denials and reimbursement issues and escalate concerns to management when appropriate.
• Work collaboratively with coding, credentialing, front office, and clinical departments to resolve claim-related issues.

Process Improvement & Compliance:

• Maintain knowledge of payer guidelines, billing regulations, and reimbursement policies.
• Assist in identifying workflow improvements to increase collections and reduce AR aging.
• Ensure compliance with HIPAA and all applicable Commercial, Work Compensation, PIP and Personal Injury payer requirements.
• Support departmental goals related to collections, account resolution, and aging reduction

Documentation & Reporting:

• Maintain accurate and detailed notes on accounts, personal injury accounts and payer communications.
• Prepare reports related to AR performance, denial trends, and outstanding balances as requested.
• Track and monitor productivity and account resolution metrics.
• Assist with audits and provide supporting documentation when required.

Customer Service & Communications:

• Communicate professionally with referral sources, insurance representatives, patients, providers, and internal staff.
• Respond promptly to inquiries regarding account balances, claim status, and payment activity.
• Provide exceptional customer service while maintaining confidentiality and professionalism.
• Support team initiatives and contribute to a collaborative work environment.

Minimum Qualifications :

• Minimum of two (2) years of accounts receivable experience in a healthcare setting.
• Minimum of one (1) year of medical or personal injury billing experience
• Prior experience with insurance follow-up, denial management and appeals.

Preferred Qualifications :

• Prior knowledge and experience of commercial, worker’s comp, PIP and personal injury claims.

Physical Work Requirements :

• Ability to alternate between sitting and standing for extended periods.
• Ability to read computer screens, and forms with accuracy, including prolonged screen time.
• Ability to lift and carry office supplies, files, and packages weighing up to approximately 15–25 pounds.