Accounts Receivable Representative

The Accounts Receivable (AR) Representative manages and resolves outstanding patient and insurance account balances to ensure timely reimbursement and accurate account resolution.

This role 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.

Responsibilities

• Communicate with patients about billing questions, insurance concerns, outstanding balances, and payment deadlines with professionalism and empathy.
• Maintain patient accounts within the billing system to generate invoices, collect and process payments, post receipts, and secure revenue while following fair credit practices.
• Review and scrub claims for proper coding and clean submission.
• 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 and 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 companies for upcoming procedures.
• Perform other duties as assigned.

Work Conditions

• Work is performed at the main clinic in Wausau, Wisconsin.
• Travel to satellite locations and surrounding communities may be required at times.
• Hours depend on clinic needs.
• Role requires sitting and/or standing for extended periods.
• Occasional lifting up to 30 pounds, bending, stooping, pushing, pulling, and climbing stairs may be required.