Patient Account Specialist

Job Summary

Educational Requirements

• High School Diploma

Qualifications and Experience

• Typing Skills/ Computer
• Pleasant speaking voice and demeanor
• Good communication skills
• Neat, professional appearance
• Previous medical office experience preferred
• experience dealing with the public
• collecting money/balancing daily

General Duties

Checks patients in and out at front desk

Answers incoming phone calls

Responds to written and telephone inquiries from patients regarding their insurance questions

Verifies insurance information prior to patients office visit

• Assists with processing all paper and electronic claims for assigned carriers-verifies completeness of paper insurance claim information before mailing
• Assists with reviewing EOBs’ and follows up on rejected claims in a timely manner as needed
• Counsels patients regarding insurance and financial issues
• Verifies insurance benefits and explains to patients
• Collects co-pays, etc from patients
• Submits balanced charge batches to the Data Entry Coordinator
• Calls carriers to appeal payments that do not match contractual agreement; notifies Executive Director of payer’s for which this is a consistent problem
• Asks physicians to provide appeal language for denials or unacceptable payment
• Processes requests for refunds, and submits to Financial Coordinator for approval
• Prepares monthly insurance tracking report and distributes to responsible staff for follow up no later than the 5th of each month
• Using data from the monthly insurance tracking report, calls payers or looks up claims status online to inquire about unpaid insurance claims that are 45 days old; records response or activity in the computer system “transaction notes”
• Provides financial assistant with a copy of the completed previous month insurance tracking report(including follow up notes) by the 5th of each month
• Maintains detailed knowledge of practice management, EHR, and other computer software as it relates to job functions
• Makes necessary arrangements for medical records requests, completion of additional paperwork, etc., if payers request this information prior to payment of claims
• Uses the Managed Care Manual to support completion of assigned tasks
• Responds to written and telephone inquiries from insurance companies
• Maintains knowledge of “on call schedule” and performs as back up when needed
• Attends all staff meetings
• All other duties as assigned

Job Type: Full-time

Pay: From $10.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Retirement plan

Schedule:

• Monday to Friday

COVID-19 considerations:
Vaccine Required

Ability to commute/relocate:

• Sumter, SC 29150: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Customer service: 1 year (Preferred)
• Microsoft Word: 1 year (Preferred)

Work Location: One location