Account Services Representative

Abrams EyeCare; Carmel (IN); Hybrid; USD 42,000 - 54,000; Full time

Job summary

Abrams EyeCare in Carmel, IN is seeking an Account Services Representative responsible for insurance claims preparation, filing, data entry of surgical and clinic charges, and AR aging.

You will work full-time in a hybrid schedule, coordinating with front desk and management to ensure accurate billing, timely payments, and responsive customer service.

The role requires 2-3 years of medical/vision insurance experience, knowledge of ICD-10/CPT, and strong computer skills.

Qualifications

• High school diploma or equivalent required.
• 2-3 years of Medical/Vision insurance experience.
• 2-3 years of Ophthalmology/Optometry coding experience.
• Knowledge of ICD-10, CPT coding and HCPCS.

Responsibilities

• Executes and posts accurate payments/write-offs according to patient’s insurance plan and secures payments until posted.
• Reviews and balances daily business activities along with checks for deposits and generates necessary reports.
• Coordinates with front desk on any fee sheet or charge discrepancies and assists front desk personnel as needed with insurance-related questions.
• Performs claim edits with TK Software (Claims Clearinghouse).
• Administers daily claims activity along with third party submissions (paper claim handling).
• Determines necessary EOBs, reports, or original claim forms as needed for appeals.
• Contacts insurance companies requesting policy and coverage limits, deductible amounts, and any pre-existing clauses on surgeries or when coverage is in question.
• Administers compilation of insurance ageing reports and act upon per schedule.
• Determines and corrects filing of incorrect payment amounts or denials.
• Determines patient and insurance refunds and report to bookkeeper to issue check.
• Manages patient billing inquiries in a timely manner (24-hour turnaround ideal).
• Coordinates with Business Office Manager if patterned insurance discrepancies are found.
• Handles customer inquiries on billing and insurance matters.
• Reviews and responds to COO and/or Director of Practice Administration on collections capture.
• Assists with training of billing staff members.
• Insurance credentialing and fee schedule negotiations.

Skills

Insurance billing

Data entry

Customer service

AR aging

Education

High school diploma

Tools

TK Software

NextGen EMR

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Account Services Representative

ADMINISTRRATIVE SALARIES Full Time Hybrid

6 days ago Requisition ID: 1015

Job Summary: Responsible for all insurance claims preparation, filing, data entry of surgical and clinic charges, medical record request, processing payments, AR aging, overseeing collections and collection reports.

Working Hours: Monday through Friday. 7:30am – 4:00pm; 8:00am – 4:30pm, 8:30am – 5:00pm

Required Qualifications:

• High school diploma or equivalent
• 2-3 years of Medical/Vision insurance experience
• 2-3 years of Ophthalmology/Optometry coding experience
• Knowledge of ICD-10, CPT coding and HCPCS

Preferred Qualifications:

• Insurance credentialing
• NextGen EMR experience
  • Knowledge of:
  • Medicare, Medicaid and Commercial Insurance
  • Local Medical Review Policies (LMRP), Correct Code Initiative (CCI) edits, MACRA/MIPS/HIPAA/Medical Records Handling
  • Review of Chart Audits
  • Handling issues such as medical necessity, claim edits, claim denials, bundling issues, charge, and payment capture
• Computer Skills: Skilled with computers, takes advantage of new technology, learns new tools quickly, uses technology to enhance job performance
• Customer Service: Works well with customers, promotes a positive image of the company, strives to solve issues raised by customers
• Efficiency: Plans and manages time well, cost conscious and identifies opportunities to streamline or improve processes.
• Productivity: Manages workload, works efficiently, meets goals and objectives

Primary Responsibilities:

• Executes and posts accurate payments/write-offs according to patient’s insurance plan and secures payments until posted
• Reviews and balances daily business activities along with checks for deposits and generates necessary reports
• Coordinates with front desk on any fee sheet or charge discrepancies and assists front desk personnel as needed with insurance-related questions
• Performs claim edits with TK Software (Claims Clearinghouse)
• Administers daily claims activity along with third party submissions (paper claim handling)
• Determines necessary EOBs, reports, or original claim forms as needed for appeals
• Contacts insurance companies requesting policy and coverage limits, deductible amounts, and any pre-existing clauses on surgeries or when coverage is in question
• Administers compilation of insurance ageing reports and act upon per schedule
• Determines and corrects filing of incorrect payment amounts or denials
• Determines patient and insurance refunds and report to bookkeeper to issue check
• Manages patient billing inquiries in a timely manner (24-hour turnaround ideal)
• Coordinates with Business Office Manager if patterned insurance discrepancies are found
• Handles customer inquiries on billing and insurance matters
• Reviews and responds to COO and/or Director of Practice Administration on collections capture
• Assists with training of billing staff members
• Insurance credentialing and fee schedule negotiations

Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.
Work Environment : Frequent mobility and/or sitting required for extended periods of time. Manual dexterity for using a calculator and computer keyboard. Some bending and stooping required.
Mental/Physical Requirements : Work is performed in a busy office environment and requires both desk and counter work. Frequent contact with patients and outside agencies. Continual patient contact may involve dealing with angry or upset people.

Other Duties as Assigned: This document is not intended to be an exhaustive list of all responsibilities, skills, and working conditions. Some variations in task assignments may be necessary from time to time. An employee may be assigned or requested to perform other related duties.