Accounts Receivable Representative

The Accounts Receivable (AR) Representative is responsible for managing and resolving outstanding patient and insurance account balances to ensure timely reimbursement and accurate account resolution. This position works closely with insurance carriers, patients, providers, and internal departments to research billing issues, follow up on unpaid claims, process adjustments when appropriate, and maintain compliance with clinic policies and regulatory requirements. Primary Header Here Communicate with patients about billing questions, insurance concerns, outstanding balances, payment deadlines, etc. with professionalism and empathy Maintain patient accounts within billing system to generate invoices, collect/process payments, post receipts, secure revenue while adhering to fair credit practices Review and scrub claims for proper coding and clean submission Review and follow up on outstanding insurance and patient accounts receivable. Investigate and resolve denied, rejected, underpaid, or delayed insurance claims. Contact insurance companies to obtain claim status, payment information, and resolve discrepancies. Submit corrected claims, appeals, and supporting documentation as needed. Post account adjustments in accordance with clinic policies and contractual agreements. Monitor aging reports and prioritize follow-up activities to reduce outstanding balances. Review explanation of benefits (EOBs) and remittance advice to ensure accurate payment processing. Identify billing trends and recurring issues; communicate findings to management. Work with patients regarding account balances, payment arrangements, and billing questions. Maintain accurate documentation of all account activities and communications within the practice management system. Collaborate with coding, billing, registration, and clinical staff to resolve claim and payment issues. Ensure compliance with HIPAA, payer regulations, and clinic policies. Assist with month-end reporting and special projects as assigned. Obtain prior authorization from patient insurance company for upcoming procedures prior to procedure date Other duties as assigned Experience High school diploma or equivalent required. Associate degree in healthcare administration, business, accounting, or related field preferred. Experience in customer service, medical accounts receivable, medical billing, or revenue cycle experience preferred. Experience working with commercial insurance, Medicare, Medicaid, and other third-party payers is a plus. Proficient in electronic medical record (EMR) and practice management systems. Strong analytical and problem-solving skills. Excellent communication and customer service abilities. Strong attention to detail and organizational skills. Ability to manage multiple priorities and meet productivity goals. Proficiency with Microsoft Office applications, including Excel and Outlook. Ability to maintain confidentiality and handle sensitive information appropriately. Working Conditions Work is performed at the main clinic; 800 N. First Street, Wausau, WI. Travel to satellite locations and communities we serve will be required at times. Hours of work will depend on the needs of the Clinic. This position requires the ability to sit and/or stand for extended periods of time. Occasional lifting (30 pounds), bending, stooping, pushing, pulling, and climbing stairs is required. Acknowledgement This job description describes the general nature and level of work of this role and is not intended to be a comprehensive list of all duties, responsibilities, or qualifications. Responsibilities/requirements may evolve to align with Clinic priorities and additional duties may be assigned to meet Clinic needs. Reasonable accommodations will be provided for qualified individuals with disabilities in accordance with applicable laws. #J-18808-Ljbffr Eye Clinic of Wisconsin