Patient Accounts Specialist I (Follow-Up Team)

More About The Patient Accounting Non-Government Follow-Up South Team:

The Non-Governmental Follow-Up South Department works all Commercial, HMO, MCO, Medicare Advantage and Workers’ Comp payers for the two DC MedStar Health hospitals. The team does “follow up” on accounts that have been billed and no payment has been received or when only partial payment is received. The team issues written appeals for denials. The DC facilities work off a contract-based reimbursement system, so all South team members are familiar with all the contracts for each payer for each facility. To make it more manageable, each team member has a dedicated payer or group of payers, depending on the volume that they work. Team members are cross trained as needed.

Interprets, evaluates, and resolves complex administrative and patient account issues. Assists with identifying and escalating payer issues in a timely manner. Processes and completes the daily workload of claims assigned, reporting backlogs as identified. Identifies registration errors and flags accounts using the error tracking process. Works in a team environment.

Education/Training
• High school graduation or equivalent.
Experience
• 1 year experience in patient accounting, accounts receivable, or related field, or an equivalent combination of experience and college education in a related field.
License/Certification/Registration
• No special certification, registration or license required.
Knowledge, Skills & 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-10 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.

• Attends training sessions and workshops offered, to include but not limited to, AAHAM certification, 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 and meets a minimum of 95% of established productivity standard.
• Maintains departmental quality assurance (QA) standard of 95% or better.
• Meets monthly departmental key performance indicators (KPIs) as it applies to open receivable, aged AR, credit balances, and high dollar accounts.
• Participates in PFS workgroups, staff meetings and work events.
• Performs other duties as assigned.
• Contributes to the achievement of established departmental and Patient Financial Services (PFS) goals and objectives, and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.