Emerus Holdings, Inc.
Overview
We are Emerus, the leader in small-format hospitals. We partner with respected health systems to provide compassionate, comprehensive care in local neighborhoods. Our commitment to patient care extends beyond norms, and we foster a work environment focused on teamwork, diversity, equity and opportunity for all healthcare professionals. This position is located in Spring, TX. The purpose of this position is to assist the Patient Account Supervisor in managing the company’s outstanding receivables, through routine communication with all payers (e.g., commercial insurance, Medicare, private pay patients, etc.) to ensure that expected reimbursement for patient care is processed timely and paid accurately. This position may work alongside staff and provide direction to less experienced staff in conjunction with the Patient Account Supervisor. Responsibilities
Assists in assigning staff workloads and shift priorities as necessary Follow up on submitted claims (e.g., claim received, pending, processing, paid) and take action to ensure timely reimbursement Routinely communicate with payers regarding delinquent or denied claims, address issues and clear barriers to payment Manage claim details and verify accurate reimbursement, initiate account adjustments and/or appeals on payment disputes File appeals for denied claims and follow-up through appeal resolution Manage and maintain outstanding patient balances to ensure accurate accounts receivable reporting Verify benefits using online/telephonic resources and ensure claims are processed according to appropriate benefit levels Assist in the review of refund requests for accuracy and submit as necessary Assist in the review of adjustment requests for accuracy and submit as necessary Assist in developing and training workflow processes for staff and payer behavior responses Work on special projects and provide ad hoc review of claims as assigned by Supervisor/Director/CFO Collaborate with CBO intra-departments to resolve pending claim activities Meet position goals related to accuracy and productivity (e.g., days in AR, cash collections) Attend staff meetings and other mandated company meetings as required Perform additional duties as assigned Qualifications
High School Diploma or GED, required 3+ years relevant experience in a provider inpatient or outpatient setting, required Advanced knowledge of claims processing, appeals, medical terminology, accounts receivable, claim forms, billing, insurance verification, adjustments and refunds, claims status, and reimbursement 2+ years of previous team leader/supervisory experience or equivalent, required Advanced knowledge of payer insurance groups, including Medicare, Medicaid and government managed care experience, required Experience with medical records or patient accounting systems, required Knowledge of state and federal payment laws to ensure prompt and accurate reimbursement, required Advanced knowledge and understanding of healthcare EOBs, required Experience with Microsoft Office (Outlook, Excel, Word), required Effective and professional written and oral communication skills Fluency in English; written and oral communication Seniority level
Mid-Senior level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care Referrals can increase your chances of interviewing at Emerus Holdings, Inc. by 2x. Get notified about new Patient Account Specialist jobs in Spring, TX.
#J-18808-Ljbffr
We are Emerus, the leader in small-format hospitals. We partner with respected health systems to provide compassionate, comprehensive care in local neighborhoods. Our commitment to patient care extends beyond norms, and we foster a work environment focused on teamwork, diversity, equity and opportunity for all healthcare professionals. This position is located in Spring, TX. The purpose of this position is to assist the Patient Account Supervisor in managing the company’s outstanding receivables, through routine communication with all payers (e.g., commercial insurance, Medicare, private pay patients, etc.) to ensure that expected reimbursement for patient care is processed timely and paid accurately. This position may work alongside staff and provide direction to less experienced staff in conjunction with the Patient Account Supervisor. Responsibilities
Assists in assigning staff workloads and shift priorities as necessary Follow up on submitted claims (e.g., claim received, pending, processing, paid) and take action to ensure timely reimbursement Routinely communicate with payers regarding delinquent or denied claims, address issues and clear barriers to payment Manage claim details and verify accurate reimbursement, initiate account adjustments and/or appeals on payment disputes File appeals for denied claims and follow-up through appeal resolution Manage and maintain outstanding patient balances to ensure accurate accounts receivable reporting Verify benefits using online/telephonic resources and ensure claims are processed according to appropriate benefit levels Assist in the review of refund requests for accuracy and submit as necessary Assist in the review of adjustment requests for accuracy and submit as necessary Assist in developing and training workflow processes for staff and payer behavior responses Work on special projects and provide ad hoc review of claims as assigned by Supervisor/Director/CFO Collaborate with CBO intra-departments to resolve pending claim activities Meet position goals related to accuracy and productivity (e.g., days in AR, cash collections) Attend staff meetings and other mandated company meetings as required Perform additional duties as assigned Qualifications
High School Diploma or GED, required 3+ years relevant experience in a provider inpatient or outpatient setting, required Advanced knowledge of claims processing, appeals, medical terminology, accounts receivable, claim forms, billing, insurance verification, adjustments and refunds, claims status, and reimbursement 2+ years of previous team leader/supervisory experience or equivalent, required Advanced knowledge of payer insurance groups, including Medicare, Medicaid and government managed care experience, required Experience with medical records or patient accounting systems, required Knowledge of state and federal payment laws to ensure prompt and accurate reimbursement, required Advanced knowledge and understanding of healthcare EOBs, required Experience with Microsoft Office (Outlook, Excel, Word), required Effective and professional written and oral communication skills Fluency in English; written and oral communication Seniority level
Mid-Senior level Employment type
Full-time Job function
Health Care Provider Industries
Hospitals and Health Care Referrals can increase your chances of interviewing at Emerus Holdings, Inc. by 2x. Get notified about new Patient Account Specialist jobs in Spring, TX.
#J-18808-Ljbffr