Patient Account Representative (Back-End Processing) – Prosthetics amp; Orthotics Medical Office
Job Type: Full-Time
Location: Wilmington, Delaware
Position Summary
We are seeking a detail-oriented and organized Patient Account Representative to join our Prosthetics and Orthotics (P amp;O) team. This position is responsible for the back-end processing of patient accounts, ensuring all documentation, insurance requirements, and billing paperwork are complete and accurate before patients can receive their devices and claims are submitted. The ideal candidate is highly organized, enjoys working behind the scenes, and has experience navigating insurance and medical documentation in a fast-paced healthcare environment.
Key Responsibilities
- Review patient files for completeness and accuracy before claim submission.
- Verify and obtain required documentation, including physician orders, clinical notes, and Letters of Medical Necessity (LMNs).
- Process insurance authorizations and ensure all payer-specific requirements are met.
- Prepare and organize documentation for billing and reimbursement.
- Follow up with physicians' offices, patients, and insurance companies to obtain missing information.
- Monitor outstanding documentation and resolve deficiencies promptly.
- Maintain accurate electronic patient records in compliance with HIPAA regulations.
- Work closely with clinicians, front office staff, and billing personnel to ensure timely processing of patient accounts.
- Assist with claim corrections, denials, and appeals by gathering supporting documentation.
- Perform other administrative duties as assigned.
Qualifications
- High school diploma required
- Minimum of 1–2 years of experience in medical office administration, medical billing, insurance verification, or patient accounts preferred.
- Experience with prosthetics and orthotics, durable medical equipment (DME), or healthcare reimbursement is highly desirable and a Plus, but not necessary.
- Knowledge of Medicare, Medicaid, and commercial insurance guidelines is a plus.
- Strong attention to detail and organizational skills.
- Excellent written and verbal communication skills.
- Proficient with electronic medical records (EMR) systems and Microsoft Office applications.
- Ability to prioritize multiple tasks while meeting deadlines.
- Commitment to maintaining patient confidentiality and HIPAA compliance.
Preferred Skills
- Familiarity with medical terminology.
- Experience working with insurance authorizations and documentation requirements.
- Strong problem-solving and analytical skills.
- Ability to work independently and collaboratively within a team.
Benefits
- Competitive salary
- Health, dental, and vision insurance
- Paid time off and holidays
- Retirement plan with employer contribution
- Supportive team environment
Why Join Our Team?
Our company is dedicated to improving the lives of patients through high-quality prosthetic and orthotic care. As a Patient Account Representative, you'll play a vital role in ensuring patients receive the coverage and services they need by keeping documentation and insurance processes running smoothly. Your attention to detail directly contributes to excellent patient care and the financial health of our practice.