N00115 – Patient Accounts Specialist
Working under the direction of the Supervisor of Patient Accounts, incumbent may be responsible for a variety of duties including billing follow-up, self-pay collections, payment posting, patient registration as well as others as assigned.
- Prepares and submits clean claims to various insurance companies either electronically or by paper.
- Manage charge entry process.
- Manage unbilled claims; research and resolve issues as appropriate.
- Manage credit/adjustment reports.
- Navigate through 3rd party payer rules and regulations.
- Maintain current knowledge of payer regulations.
- Assist with maintaining AR days within goal of 45 days.
- Performs the correct revenue cycle process (i.e. billing or payment posting functions) to adjudicate claim within payers timely filing guidelines.
- Makes deposits utilizing remote processes as well as processing credit card transactions.
- Manage rejections from clearinghouse.
- Responsible for providing effective and accurate processing and posting of insurance payments; both manually and/or electronically.
- Responsible for providing effective and accurate processing and posting of client (consumer) payments manually.
- Receives and researches potential refunds, write off codes, and credit transfer.
- Manages payment posting / deposit log.
- Resolve discrepancies in terms of inaccurate payment levels received.
- Meets / exceeds performance expectations and completes payment posting functions within the required time frames.
- Performs office related support tasks, clerical duties and/or general office duties which may include creating reports, typing, filing, faxing, answering telephones, taking messages, and making copies.
- Generates reports and takes actions to report on Key Performance Indicators such as clean claim rate, days in AR, bad debt %, etc.
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- May work with front desk staff at treatment facilities to resolve issues.
- Attention to detail, initiative, and judgment.
- Must exhibit poise, tact, and compassion dealing with patients.
- Performs other duties and special projects as assigned.
Education and Experience:
- High school diploma or equivalent GED
- 2+ years’ experience in a position meeting and communicating with the public.
- 2+ years of billing, payment posting, or A/R experience in a healthcare setting
- Proficient in Microsoft Office Suite, especially Excel
Customer Service: Demonstrates concern for meeting internal and external customers’ needs in a manner that provides satisfaction for the customer within the resources that can be made available.
Integrity: Upholds personal and professional ethics and values, taking into account the values of RCA and respecting the culture, beliefs and abilities of individuals.
Ability to effectively deal with difficult people: the ability to respond to difficult customer behavior with diplomacy and tact including defusing anger, creating rapport an influencing behavior.
Work Environment: May work in a variety of environments including professional offices, clinics, hospitals, or out-patient facilities. They spend much of their time on their feet, actively working with patients.
Physical Demands: While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands to finger, handle or feel objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move objects up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus.
Travel: Travel is primarily local during the business day, although some out-of-the-area and overnight travel may be expected