Patient Accounts Specialist I Physicians' Billing

MedStar Physicians’ Billing Services has an opening for an experienced Patient Accounts Specialist (Level I) to join our team and work remote from home! 

To be successful, candidates must have a minimum of 2 years collection experience in medical billing operations. We are specifically looking for a candidate that has experience with facility and/or physician claims follow-up, researching claim denials and preparing/writing appeals to get claims paid.  

Job Description:   Performs accounts receivable follow-up/collection procedures to obtain timely reimbursement from third party carriers and other payment sources on insurance invoice balances. Performs collection activity for assigned divisions, third party carriers and individual providers. Maintains contacts with third party carriers and communicate billing/reimbursement changes to management in timely manner. Assists in evaluation of accounts receivable and participate in development of collection strategies to decrease outstanding balances.

Primary Duties and Responsibilities: 

·       Assists in maintaining integrity of the accounts receivable system database by reviewing data input for completeness and accuracy - including updating account information and transferring charges to correct financial class.

·       Collects and determines follow up needed on outstanding accounts receivable with an invoice balance less than or equal to $3,000.

·       Follows appeal procedures for denied claims and reimbursement below contractual fee schedule.

·       Identifies patient/third party carrier complaints, resolves and communicates these complaints to management.

·       In accordance with operational policies and procedures, makes adjustment to patient accounts as necessary to facilitate timely reimbursement.

·       Maintains collection follow-up notes utilizing GE IDXETM software.

·       Meets the Performance ETM Production quota set at 100% of the established quota.

·       Monitors assigned accounts receivable categories until payments are received and posted.

·       Obtains necessary billing/appeal information from provider/division/electronic record/billing contact/patient to facilitate timely claim/appeal adjudication.

·       Provides supporting documentation at time of claim appeal to facilitate timely reimbursement.

·       Reports status of delinquent accounts.

·       Resolves billing issues if necessary.

·       Uses support capabilities of accounts receivable billing system to obtain appropriate information and work product.

Qualifications:  

• High School Diploma or GED required
• 2 years collection experience in medical billing operations required
• Experience and proficiency using an automated billing system, GE IDX and ETM experience preferred
• Knowledge of ICD9/10 and CPT4 coding as it relates to third party carrier reimbursement.
• Knowledge of federal, state and local legal and regulatory provisions that relate to collection activities.
• Knowledge of third party carrier operating procedures and practices -- particularly as they relate to levels and methods of reimbursement.
• Proven skill in defining problems, collecting data, interpreting billing information.
• Ability to examine documents for accuracy and completeness, to prepare records in accordance with detailed instructions.
• Excellent organizational and analytical skills that ensure successful and accurate completion of daily quota driven processing.

• Proficiency in use of computer and calculator.
• Effective verbal and written communication skills.