All-Pro Placement Service, Inc.
Patient Accounts Specialist - Collections
All-Pro Placement Service, Inc., Baltimore, Maryland, United States, 21276
Overview
The patient accounts specialist II prepares and follows-up all third party and patient bills, as organized and directed by the Patient Finance Manager/Director. Qualifications
High School Diploma or GED 3 years prior experience in hospital collections. Strong payer knowledge base. Extremely accurate with figures and data entry. Strong analytical skill a must. Must be able to work unsupervised. Must be able to work with a calculator, PC and Excel Responsibilities
Review and assess adjudicated claims for timely and proper payment of outstanding balances Research, correct and resubmit or reprocess unpaid claims as necessary Submit adjustment request daily as necessary Verify validity of account balances by researching, review and ensuring accuracy of charges, payments and adjustment posting and ensure account balances are assigned to the correct payer buckets Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes Research and resolve denials and underpayments with insurance carriers Identify payer denial trends Confirm insurance eligibility and confirm carrier policy for referral and auth requirements as needed for claim adjudication Submit carrier appeals and reconsideration request in a timely manner Identify and submit the required insurance refund request to refund specialist according to policy and procedure Meet productivity goals/benchmarks as set and communicated Department leadership Serve as a customer service representative for patient inquiries/calls Maintain confidentiality of patient information Work collaboratively with other departments and coworkers as needed Attend quarterly payer meeting with respective payers
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The patient accounts specialist II prepares and follows-up all third party and patient bills, as organized and directed by the Patient Finance Manager/Director. Qualifications
High School Diploma or GED 3 years prior experience in hospital collections. Strong payer knowledge base. Extremely accurate with figures and data entry. Strong analytical skill a must. Must be able to work unsupervised. Must be able to work with a calculator, PC and Excel Responsibilities
Review and assess adjudicated claims for timely and proper payment of outstanding balances Research, correct and resubmit or reprocess unpaid claims as necessary Submit adjustment request daily as necessary Verify validity of account balances by researching, review and ensuring accuracy of charges, payments and adjustment posting and ensure account balances are assigned to the correct payer buckets Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes Research and resolve denials and underpayments with insurance carriers Identify payer denial trends Confirm insurance eligibility and confirm carrier policy for referral and auth requirements as needed for claim adjudication Submit carrier appeals and reconsideration request in a timely manner Identify and submit the required insurance refund request to refund specialist according to policy and procedure Meet productivity goals/benchmarks as set and communicated Department leadership Serve as a customer service representative for patient inquiries/calls Maintain confidentiality of patient information Work collaboratively with other departments and coworkers as needed Attend quarterly payer meeting with respective payers
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