Medical Billing and Patient Account Representative

Medical Billing and Patient Account Representative

Location: Decatur, GA & Stockbridge, GA

Work Arrangement: In-person

Pay rate: $18-$25/hour based on experience

Schedule: Monday-Friday 8am-5pm. No weekends or evenings!

Position Summary

We are seeking an experienced Medical Billing and Patient Account Representative to manage the billing, including charge entry and claims submission, as well as patient communication regarding their bills. This individual will also support payment posting, insurance follow-up, and reimbursement activities.

Essential Responsibilities

• Serve as a point of contact for patient billing inquiries and coordinate communication between patients, providers, and billing teams.
• Assign appropriate diagnosis and procedure codes based on operative notes, clinical documentation, and encounter records.
• Enter charges and submit electronic claims within 48 hours of the date of service.
• Verify contractual adjustments and ensure accurate billing and collections processes.
• Review and correct electronic billing reports daily to ensure claims are submitted accurately and promptly.
• Provide documentation to insurance carriers and third-party payers as requested.
• Review Medicare claims to ensure compliance with applicable guidelines and regulations.
• Maintain current coding references and stay informed of coding updates and revisions.
• Maintain accurate insurance records, payer information, and contract files.
• Communicate insurance changes and reimbursement updates to appropriate staff members.
• Ensure compliance with all local, state, federal, and payer-specific billing requirements.
• Protect patient confidentiality and maintain HIPAA compliance for medical and financial information.
• Assist with prior authorizations and patient scheduling as needed.
• Generate and analyze EHR reports to identify:
  • Missing encounter slips within established timeframes
  • Claim rejections and denials requiring follow-up
• Perform other duties as assigned.

Qualifications

Required

• Medical billing experience within pain management
• Working knowledge of Explanation of Benefits (EOBs)
• Experience with both government and private payers
• Knowledge of workers' compensation billing and reimbursement processes
• Experience with personal injury billing and reimbursement
• Strong organizational, time management, and multitasking skills
• Excellent attention to detail and accuracy
• Ability to work independently and collaboratively within a team environment

Preferred

• Experience using Athena, eClinicalWorks, or other EHR systems
• Experience with prior authorizations and scheduling
• Experience creating or updating departmental policies and procedures

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.