Medix
We are seeking a professional, reliable, and detail-oriented Account Representative to join our Revenue Cycle team. In this critical role, you'll serve as the primary liaison between healthcare providers, insurance carriers, and internal revenue staff to ensure timely and accurate reimbursement for services rendered. The ideal candidate will have experience navigating complex claim scenarios and a strong understanding of insurance billing and denial resolution. Key Responsibilities: Insurance Claim Management: Partner with insurance carriers to ensure timely payment of outstanding claims Submit claim corrections, troubleshoot payment delays, and document account activity Request and review medical records or reports to support claim follow-up Claim Status Monitoring: Access payer portals to monitor pending claims Identify payer trends, escalate delays or systematic issues, and communicate with billing staff Appeals and Denials Resolution: Process timely appeals for denied or underpaid claims Resolve issues such as bundling, global periods, medical necessity denials, or insufficient documentation Data & Documentation: Maintain accurate account records and update EMR systems Prepare and review A/R and aging reports Team Collaboration & Results: Meet individual and departmental A/R goals Prioritize quality work over speed, while managing time effectively Must-Have Qualifications: 3+ years of experience in medical billing, A/R follow-up, or health insurance Strong understanding of insurance guidelines, billing practices, and claim cycles High school diploma or equivalent Proficiency in Windows-based systems and EMRs (NextGen PM, Epic preferred) Ability to troubleshoot and resolve issues independently and communicate effectively Nice to Have: Knowledge of denial types such as medical necessity, bundling/global services, and non-contracted reimbursement Experience in a dialysis, hospital, or multi-specialty practice environment Soft Skills: Organized, dependable, and proactive Positive attitude with strong communication skills Comfortable working under pressure and meeting deadlines High standard of professionalism and accountability Perks & Benefits: Full benefits package (details available upon request) Supportive team culture Option to move to a 4x10 workweek after proving proficiency post-conversion