Patient Accounts Specialist-Account Resolution

The Patient Accounts Specialist – Account Resolution reconciles and resolves open accounts balances. In addition, researches and resolves questions about accounts and makes appropriate adjustments.

Knowledge, Skills & Abilities
• Reads, speaks, understands and writes proficiently in English.
• Independent and self-directed.
• Works effectively in a team environment.
• Problem-solves with creativity and ingenuity.
• Organizes, prioritizes, and coordinates multiple activities and tasks.
• Works with initiative, energy and effectiveness in a fast-paced environment.
• Produces work in high quantity and quality.
• Remains calm and effective in high pressure and emergency situations.
• Use of multi-line telephones and other office machines.
• 10-Key: 150 kpm with a 97% accuracy rate.
• Knowledge of medical terminology.
• Proficiency in the use of Microsoft Office applications; Word, Excel and Outlook.

Preferred:
• Knowledge of dental terminology.
• Bilingual skills. Education
• High school graduate or equivalent.

Preferred:
• Graduate of an accredited Medical Billing Certificate program.

Experience
• Customer service related experience working with the general public (2 years).
• ICD-10 coding experience.
• CPT-4 coding experience.
• Working with insurance/billing in a healthcare setting (2 years).
• Healthcare information systems, such as electronic health record and practice management systems experience (3 years).
• Working with private and/or government third party reimbursement (1 year).

Preferred:
• CDT-5 coding experience.
• Working with low income, multi-ethnic populations.

Credentials Preferred:
• Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) or Coding Specialist (CCS) certified by the American Health Information Management Association (AHIMA).

Job Specific Functions/Performance Expectations:
1.  Verifies insurance coverage and submits claims to insurance companies.
2.  Bills primary, secondary and tertiary insurances.
3.  Assists in verification of proper CPT and diagnosis coding is entered in the practice management system based on the level of service provided and documented in the electronic health record by provider.
4.  Assists patients in setting up payment plans and completes payment plan contracts.
5.  Assists with posting daily charges submitted from electronic health record and audit their accuracy.
6.  Posts daily payments to practice management system and enter contractual adjustments, as necessary.
7.  Assists in processing daily reports to clinics of electronic charge entry corrections and tracks their return.
8.  Adheres to quality and quantity standards of the department, which includes but is not limited to a minimum of 97% accuracy on quality of work and the ability to review, code, and resolve 45 claims per day.
9.  Be a resource for staff on all aspects of insurance programs, discount applications, provider coding, payment plans and patient payment processing.
10.  Performs A/R resolution, including researching denied and incomplete claims and appeals.
11.  Ensures that all payments, adjustments and denials are posted timely and accurately.
12.  Performs various collection actions, including but not limited to correcting and resubmitting claims to third party payers and tracking and reporting delinquent accounts to collection agency.
13.  Prepares and sends patient statements.
14.  A process discount fee adjustments and enters tracking data into sliding fee database.
15.  Assists patients in completing applications and qualifying for fee discount program.
16.  Scans various documents, including but not limited to statement verifications, collections, OB billing and invoices.
17.  Researches patient questions regarding accounts/statements and initiates appropriate adjustments and/or resubmission of claim(s).
18.  Researches and reconciles patient and third party credit balances and initiates refund requests.
19.  Adheres to the department’s standards of personal phone use.
20.  Adheres to attendance standards in order to perform the job functions for daily operations and/or continuity of patient care.

We offer competitive salary and a comprehensive benefits package designed to address health, time off, retirement and career-advancement needs.  We also offer an additional $0.75/hour for those who test proficiently in a second language.

To learn more and to apply for this position, please visit our website www.CHCsno.org to complete an online application and/or submit your resume for consideration.

Join a team that loves what they do and cares about those they serve.

AA/EEO Employer