Patient Accounts Specialist I

General Summary of Position
Interprets and evaluates appeals to include follow-up with payers to assure timely turn around for claims resolution and reimbursement. Must be able interpret explanation of benefits and have a clear understanding of payer methodology. Works in a team environment.

Primary Duties and Responsibilities

• Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
• Attends training sessions and workshops offered to include but not limited to CPAT Training bulletin review etc. Attends and successfully completes required Continuing Education Units (CEU) for the PFS Training Program. Completes annual mandatory training (SITEL) within defined time frame.
• Keeps abreast of regulatory and specific changes as it relates to billing requirements and payer specific follow up.
• Maintains daily performance benchmarks as it applies to interpreting and evaluating appeals to include follow up with payers. Completes coding report updates within the standard set in a timely manner to begin the daily workflow process. Responsible for reconciliation of reports to SMS and information that was posted.
• Maintains departmental QA standard within established error rate.
• Meets team specific benchmark as it applies to completed Tracking Forms forwarded to the Operational Desk after completion on a daily basis >$10K >$20K AR15 AR30 and AR45.
• Participates in PFS workgroups staff meetings and work events.
• Participates in multi-disciplinary quality and service improvement teams.

Minimal Qualifications
Education

• High School Diploma or GED required or
• equivalent. required

Experience

• 1-2 years Experience in patient accounting accounts receivable or related healthcare field required or
• An equivalent combination of experience and college education in accounting finance or healthcare administration required

Knowledge Skills and Abilities

• Detailed working knowledge and demonstrated proficiency in at least one specific payers application billing and/or collection process.
• Requires basic working knowledge of UB04 and Explanation of Benefits (EOB).
• Requires some knowledge of medical terminology and CPT/IDC-9 coding.
• Excellent communication analytical interpersonal and organizational skills.
• Proficient uses of hospital registration and/or billing systems and personal computers as well as Microsoft Excel and Word applications.
• Ability to type 35 WPM.

USD $18.70 - USD $32.72 /Hr.