PATIENT ACCOUNT SPECIALIST

Do you have experience with claim processing and like to work with people of all ages and populations? Appy today!!

Job Summary:

Responsible for processing claims of all third party payers and private pay patients, both inpatient and outpatient; handles correspondence to and from insurance companies regarding submitted claims; makes appropriate contacts, by telephone or correspondence, with patients or insureds regarding needed information to accurately bill patient’s claim; prepares EFT vouchers from third party payers for posting to patient accounts; must be available to the public, walk-ins and telephone calls, for any inquiries; monitor and manage accounts to minimize credit balances, bankruptcies, and self-pay referrals to the extended business office.

HOURS: Part-Time, 24 hours weekly                                     

Primary Job Responsibilities:

1. Process all third-party payer claims.
2. Monitor the coding and charging of all outpatient visits, inpatient visits, surgical procedures, ancillary procedures and/or clinic procedures for appropriateness and reviews accounts for compliance with Federal and State billing requirements to payers.
3. Maintain the Epic work ques including claim edits and charge review so that accounts are billed within 4 days.
4. Maintain the Epic claim edit, denial, rejection and no response work ques for timely follow up for all payers and private pay.
5. Perform the necessary maintenance of patient accounts, i.e., correspondence, follow-ups, logs, inquires, payment arrangements, and correspondence to ensure accurate and timely communication with the extended business office.
6. Maintain a system to capture missed and/or late charges prior to submission of claims.
7. Accept and post payments via all payment methods from patients and third party payers.
8. Prepare EFT vouchers for posting to appropriate accounts.
9. Balance receipts posted to the deposit slip to be sure all receipts tie out to close the day for posting.
10. Prepare and maintain the Bad Debt Collection files and work closely with that agency.
11. Maintain the patient accounts for bankruptcy claims and take appropriate measures to remain within required Federal guidelines.
12. Reconcile credit balances on patient accounts according to the guidelines within the Financial and Collection Policy.
13. Reconcile and submit the quarterly credit balance report to Medicare and Medicaid.
14. Work with other departments to ensure best practices and processes for the entire Revenue Cycle.
15. Work closely with healthcare providers in the education of billing and coding principals.
16. Maintain knowledge of Federal and State billing requirements.
17. Maintain proper telephone etiquette.
18. Perform other duties as assigned and requested.

Job Specifications:

1. Certified Critical Access Biller/Coder, CRCS, CRCP or work equivalence preferred.
2. Experience with claim processing and denial follow up required.
3. Hospital or clinic billing experience in CAH, RHC or FFS of 3 – 5 years preferred.
4. Experience with Microsoft Word, Excel and Outlock required.
5. Medical terminology preferred.
6. Excellent computer skills required.
7. Must be able to work well with persons of all ages and nationalities.
8. Must have excellent human relations, written and oral communication skills.