The Patient Account Specialist is responsible for submitting claims to the appropriate intermediaries and to insure that procedures and charges are coded in compliance with all payer guidelines and state/federal regulations, when assigned. Under the supervision of the Director, the Patient Account Specialist is also responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement of Hospital’s receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate regulations in order to assure compliance in payment practices. Leads teams in the resolution of unpaid accounts.
EDUCATION, EXPERIENCE, TRAINING
1. Previous Billing Experience within a hospital Business Office Required.
2. Previous experience with government programs and collections preferred.
3. Knowledge of medical terminology
4. Effective written and verbal communication skills
5. Ability to multi-task, prioritize needs to meet required timelines
6. Analytical and problem-solving skills
7. Customer Services experience required
8. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf