The Patient Account Specialist is responsible for accurate and timely billing of all services delivered as well as ensuring all revenue is collected. Job Duties Ensure accurate and timely billing of claims to payers. Verify all services delivered are billed to the correct payer. Work all pre-billing/post-billing reports to ensure correct data on claims. Identify and resolve claim issues. Guarantee timely secondary billing submissions based on the payer requirements. Complete understanding of con... more details
Job Summary
The Patient Account Specialist is responsible for accurate and timely billing of all services delivered as well as ensuring all revenue is collected.
Job Duties
Ensure accurate and timely billing of claims to payers. Verify all services delivered are billed to the correct payer. Work all pre-billing/post-billing reports to ensure correct data on claims. Identify and resolve claim issues. Guarantee timely secondary billing submissions based on the payer requirements. Complete understanding of contract requirements of each payer as it relates to billing/collections (timely filing, specific invoicing requirements, etc.) Ensure timely processing of any re-billing invoices/claims. Manage any fiscal year-end billing
Follow up & troubleshoot outstanding Accounts Receivable balances. Run reports including (but not limited to) claim aging, held claims, unbilled claims. Work with the program and funding sources to correct any issues/re-bill claims. Follow up with funding sources on a regular basis to obtain status of payment on claims. Ongoing active collection engagement to minimize risk of any negative write-offs or adjustments to the AR
Develop and maintain program specific billing & collection process documentation
Work closely with various KidsPeace departments (finance, contracts, programs, etc.) to resolve any issues with payment. Facilitate resolution of discrepancies caused by payer that resulted in short/over/no pays
Conduct accounts receivable revenue cycle meetings with interdisciplinary teams on a regular basis to identify troubled accounts and payer trends. Propose solutions for reimbursement on difficult accounts. Collaborate on process improvement on the full revenue cycle process
Responsible to complete special A/R projects when rates increase/decrease retroactively. Other special projects as assigned
Qualifications
High School Diploma or equivalent required. BA/BS degree in related field with equivalent work experience preferred
Minimum 1 years’ experience in billing/collections/cash application in a healthcare setting preferred
Basic skill with the Microsoft Office suite (Outlook, Word, Excel, etc.) is required
Strong mathematical, analytic skills and attention to detail preferred
Experience with third party payers, Medicaid, Managed Care and governmental billing/collections preferred
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