Account Representative - Patient Billing Specialist

General Summary: This role involves managing the revenue cycle and general operations with a focus on delivering exceptional customer service and maintaining respectful relationships with all stakeholders.

Essential Functions: Responsible for preparing and facilitating monthly billing to all payors, including fiscal intermediaries, within timely filing deadlines. Conducts insurance verification and authorization for services according to program and insurance requirements. Manages data transmission to vendors in compliance with CMS regulations. Performs pre-billing audits, generates pre- and post-month-end reports, reconciles accounts receivable, and provides reports to accounting. Maintains knowledge of patient rights and legal considerations throughout the billing and collection process. Investigates and follows up on outstanding and unpaid claims. Prepares journal entries, reviews invoice coding, analyzes accounts, and reconciles as needed. Supports general office duties and provides backup for clerical staff to ensure timely completion of operational tasks and meet patient and staff needs. Assists with report preparation and data collection to support administrative and quality functions. Adheres to HIPAA privacy and security regulations regarding Protected Health Information (PHI).

Minimum Knowledge and Skills Required: Understanding of collection techniques and accounts receivable maintenance. Basic knowledge of Medicare, Medicaid, and commercial insurance. Effective communication skills. Proficiency with computers and calculators, especially Microsoft Office software such as Excel.

Preferred Knowledge and Skills: Familiarity with accounting principles.

Required Behavioral Skills: Integrity characterized by honesty and ethical conduct. Compassion demonstrated through empathy and excellent customer service. Ability to manage conflict, consider diverse perspectives, and offer alternative solutions while maintaining project direction. Accountability with ownership of tasks and flexibility to adapt to changing priorities. Respect for collaboration with diverse populations and a proactive service orientation. Excellence in communication, presentation, strategic thinking, leadership, and process improvement.

Minimum Education and Experience: Previous experience in healthcare third-party coordination, preferably in home care, hospice, or similar settings. Medical billing experience.

Preferred Education and Experience: Associate degree in Business with an emphasis in accounting. Additional education in accounting, coding, and medical terminology. Relevant public accounting or medical billing experience.

Required Licenses/Certifications: Valid state driver's license and proof of auto liability insurance.

This position offers competitive pay, a generous benefits package, and the opportunity to make a meaningful impact in a regional healthcare setting serving the Central Plains region of the United States.