Patient Accounts Specialist- Insurance

The purpose of this position is to assist in managing the company's outstanding receivables, through routine communication with all payers (e.g. commercial insurance, Medicare, private pay patients, etc.) to ensure that expected reimbursement for patient care is processed timely and paid accurately. Basic Qualifications High School Diploma or GED, required2+ years experience in a provider setting (inpatient or outpatient), requiredKnowledge of all payors insurance; self-pay after insurance, reimbursements, collections, appeals, claims follow-up and third party billing, requiredExperience with medical records or patient accounting systems, requiredKnowledge and understanding of state and Federal payment laws, requiredKnowledge and understanding of healthcare ‘explanation of benefits' (EOB's), requiredExperience with a 10-key adding machine, requiredPosition requires fluency in English; written and oral communication Essential Job Functions Follow up on submitted claims (i.e., claim received, pending, processing, paid, etc.) and complete action as appropriate to ensure timely receipt and appropriate reimbursementCommunicate with payers regarding delinquent or denied claims, addressing issues and clearing barriers to paymentManage claim details and verify accurate reimbursement, so as to initiate account adjustments and/or appeals on payment disputes File appeals for denied claims and follow-up as necessary through appeal resolutionManage and maintain outstanding patient balances to ensure accurate reporting of company's accounts receivableUtilize on-line/telephonic resources to verify benefits and ensure claims are processed according to the appropriate benefit levelsSubmit refund requests as necessaryWorks special projects as assigned by Supervisor/Director/CFO Other Job Functions Meet position's goals and objectives related to accuracy and productivity (e.g. days in AR, cash collections, etc.)Attend staff meetings or other company sponsored or mandated meetings as requiredPerform additional duties as assignedWillingness and ability to work overtime