The Lead Account Representative is an advanced billing and reimbursement specialist responsible for managing complex medical claims, resolving escalated account issues, and ensuring compliance with payer regulations.
This role handles high-difficulty accounts that require in-depth investigation, advanced follow-up strategies, and a strong understanding of payer rules and reimbursement requirements. The position works collaboratively with clinical and administrative departments, supports process improvements, provides insight on complex billing challenges, and helps maintain documentation standards. It plays a key role in supporting the integrity and efficiency of the revenue cycle.
Responsibilities
- Process, audit, and submit complex or high-value medical claims in accordance with payer regulations and organizational standards.
- Conduct detailed follow-up on outstanding or denied claims and coordinate corrections to secure timely reimbursement.
- Serve as a subject matter resource for billing policies and help escalate payer rule changes.
- Collaborate with clinical departments, coding teams, and registration staff to resolve claim discrepancies.
- Maintain accurate documentation of billing actions, payer interactions, and claim adjustments.
- Assist leadership with training, quality assurance reviews, and process improvements.
Qualifications
- High school diploma or equivalent strongly preferred.
- Six months of previous billing or cashier experience preferred.
- Computer experience required.
- Typing, computer, and business machine skills.
- Good communication skills.
- Good accounting aptitude.
- Ability to key quickly and accurately.
Location
North Dakota, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago