Title: Patient Accounts Specialist
Terms of Employment
• W2, Contract-to-Hire, 3 Months
• The position is fully onsite in Baltimore, MD 21209
Position Overview & Responsibilities
The patient accounts specialist II prepares and follows-up all third party and patient bills, as organized and directed by the Patient Finance Manager/Director.
• Review and assess adjudicated claims for timely and proper payment of outstanding balances
• Research, correct and resubmit or reprocess unpaid claims as necessary
• Submit adjustment request daily as necessary
• Verify validity of account balances by researching, review and ensuring accuracy of charges, payments and adjustment posting and ensure account balances are assigned to the correct payer buckets
• Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes
• Research and resolve denials and underpayments with insurance carriers
• Identify payer denial trends
• Confirm insurance eligibility and confirm carrier policy for referral and auth requirements as needed for claim adjudication
• Submit carrier appeals and reconsideration request in a timely manner
• Identify and submit the required insurance refund request to refund specialist according to policy and procedure
• Meet productivity goals/benchmarks as set and communicated Department leadership
• Serve as a customer service representative for patient inquiries/calls
• Maintain confidentiality of patient information
• Work collaboratively with other departments and coworkers as needed
• Attend quarterly payer meeting with respective payers
Required Skills & Experience
High School Diploma or GED
3 years prior experience in hospital collections.
Strong payer knowledge base.
Extremely accurate with figures and data entry.
Strong analytical skill a must.
Must be able to work unsupervised.
Must be able to work with a calculator, PC and Excel
All other duties as assigned or requested.
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