Account Representative (4007)

Position Summary:

The Account Representative supports the revenue cycle by preparing, reviewing, and submitting accurate medical claims to third-party payers in accordance with regulatory standards and payer-specific guidelines. This role ensures complete and accurate account documentation while working collaboratively with clinical teams, patient access staff, coders, and other billing personnel to gather required information and resolve discrepancies efficiently. As part of a coordinated revenue cycle team, the Account Representative contributes to timely reimbursement, reduced accounts receivable delays, and the overall financial health of the organization through consistent communication and shared accountability. This position plays an important role within a structured, supportive work environment that values teamwork, accuracy, and strong cross-departmental collaboration.

Key Responsibilities:

• Prepare, review, and submit compliant medical claims through approved billing and electronic data interchange systems.
• Verify accuracy of patient demographics, insurance information, coding, and supporting documentation prior to claim submission.
• Collaborate with internal departments to obtain missing or corrected information required for claim completion.
• Monitor the status of submitted claims, identify delays, and resolve issues that impact timely reimbursement.
• Review and correct denied or rejected claims, ensuring resubmission within payer timelines and regulatory requirements.
• Maintain comprehensive documentation of billing activities, communications, and follow up actions within the billing system.
• Recognize patterns in payer denials, documentation deficiencies, or workflow issues and notify appropriate leadership.
• Assist with internal audits and quality improvement initiatives related to billing accuracy and compliance.
• Maintain current knowledge of billing regulations, payer requirements, and updates to coding and documentation standards.