Patient Accounts Representative - Denials and Surgery Estimates

Job Summary            

This position is integral to the success of the practice by performing timely and accurate review and resolution of insurance denials and preparation of precise surgery estimations.  Ongoing work provides interaction with patients, insurance carriers, staff, and physicians.

Job Responsibilities

Primary Focus

• Reviews and resolves insurance claim denials and rejections in a timely and accurate manner
• Communicates with insurance companies to determine reasons for denial and initiates appeals when appropriate
• Collaborates with coding and clinical staff to gather necessary documentation for successful reconsideration or appeal
• Tracks trends in denials and reports patterns to Revenue Cycle leadership
• Prepares accurate and timely surgical estimates
• Validates insurance information and authorization status when estimating surgical costs
• Ensures clear, professional communication with patients regarding their out-of-pocket responsibilities
• Maintains up-to-date knowledge of payer policies and estimation tools

Secondary Duties

• Answers incoming calls to the business office as backup support
• Provides general assistance with patient accounts and insurance questions
• Maintains accurate documentation in the Practice Management System
• Assists with other duties as assigned by the Revenue Cycle Manager

Other Responsibilities

• Stays current and ensures compliance with all company policies, procedures, and guidelines
• Demonstrates behavior consistent with Dakota Eye’s Mission, Vision, and Values
• Maintains professional, timely, and consistent communication with physicians, coworkers, leadership, vendors, and patients
• Exhibits a professional demeanor while representing the practice
• Maintains a high level of confidentiality in all aspects of work

Knowledge, Skills, and Abilities

• High school diploma or GED
• Minimum of 2 years’ experience in the medical field, preferably with insurance follow-up and/or surgical coordination
• Knowledge of medical insurance carriers and denial resolution processes
• Experience in surgery estimation or prior authorization strongly preferred
• Proficiency with Microsoft Office and basic computer navigation
• Strong written and verbal communication skills, including phone etiquette
• Attention to detail and ability to meet deadlines
• Compassionate and service-oriented personality
• Team player with a proactive approach to problem-solving

Physical Requirements

• Ability to sit or stand for up to 8 hours
• Clear speaking voice and ability to hear softly spoken words

About Dakota Eye Institute

Dakota Eye Institute is a leading multi-specialty practice comprised of board-certified ophthalmologists, optometrists, and dedicated professional staff. We offer a comprehensive range of services, including eye and vision exams, cataract surgery, infant eye care, and much more. We are dedicated to providing an unprecedented level of care and responsive service to our patients.

To our staff, we are committed to providing an excellent work environment, opportunities for self-development and growth, and recognition for hard work and commitment to Dakota Eye Institute.

Our Benefits

      Dakota Eye Institute offers a generous benefits package, including:

• 401(k) Retirement with an employer contribution
• Medical and Dental Insurance
• Employer contribution to a Health Savings Account
• Vision Benefits
• Wellness Benefits
• Paid Time Away Benefits
• And more!

Apply at www.dakotaeye.com/jobs