Account Representative

Job Description

Job Description

Join Our Team!

NANI is seeking a professional, reliable, and detail-oriented Account Representative to join our Revenue Cycle team. This role interacts with a variety of health insurance organizations to ensure that NANI medical providers are paid promptly and accurately for their services. This position serves as a liaison between insurance carriers, revenue department colleagues, and NANI medical providers and is responsible for ensure for the coordination and ongoing communications with insurance carriers, to ensure payments for outstanding invoices are received within 180 days.

We offer a comprehensive benefits package including a great schedule (flexible start and end times, no weekends), medical, dental, vision insurance as well as a wide range of supplemental benefits and discount programs including tuition reimbursement. We offer a complete time off package for full time colleagues including company paid holidays and PTO.

What You’ll Do

Account Representatives are responsible for ensuring that insurance company pay their accounts with the company.

• INSURANCE CLAIM SERVICE : Partners with third-party health insurers to ensure timely and complete payments of outstanding insurance claims. Coordinates and process payments from insurance carriers and troubleshoots any issues related to these payments. This involves properly documenting claim files, requesting reports and records, reviewing medical bills and A/R reports, and engaging in regular telephone and internet communications with third-party payers to discuss claims.
• CLAIM STATUS MANAGEMENT : Monitors status of insurance claims pending payment by accessing various insurance portals. Corrects and resubmits claims to payers as necessary and notifies the billers of claim errors. Identifies payer trends and notifies manager of negative trends.
• CLAIM APPEALS : Processes timely appeal of denied, rejected, or delinquent insurance claims taking into consideration established insurance deadlines. Familiarity with complex claims denial reasons and how to appeal the denials (i.e., denials due to medical necessity, bundled/global codes & procedures, inappropriate reimbursement per contracted fee schedule, insufficient documentation, etc.). Resolves denials or partially paid claims through interaction with insurance carriers, patients, hospitals, dialysis units or physicians.
• DATA AND INFORMATION MANAGEMENT : Maintains accurate records and information, including preparing, generating and reviewing reports. Updates data discrepancies identified in reports and systems. Accurately documents pending and completed work activities using appropriate systems.
• Ensures all insurance related duties are completed in a timely and accurate manner to ensure excellent patient relations and financial success for the Practice. Achieves revenue goals by effectively managing receivables. Meets productivity as assigned by the department Manager or Supervisor.
• Other duties as assigned.

What You’ll Bring

• 3+ years of experience in a medical billing or health insurance role preferred. Knowledge of insurance guidelines and requirements, medical documentation, billing and third-party reimbursement strongly preferred.
• High school diploma or equivalent.
• Ability to solve problems and answer questions quickly.
• Computer proficiency in Windows-based applications.
• Experience with electronic medical records systems (Nextgen PM and Epic) preferred.
• Excellent time management skills and ability to multi-task and prioritize work in a fast-paced environment.
• Must be self-started who can work independently yet function in a highly collaborative, fast paced, team environment.
• Ability to work well under pressure and meet deadlines effectively.
• Strong communication and organizational skills.
• Must have a positive, friendly attitude.
• Reliability and compliance with attendance standards.