Patient Account Specialist

3 weeks ago

Baltimore, United States Chase Brexton Health Care Full time

JOB SUMMARY:
MAJOR DUTIES AND RESPONSIBILITIES:
Communication
- Clearly and effectively interacts with patients and staff around coverage or balance issues for any denials using the practice management system.
- Assures timely follow-up and communication.
- Reaches out timely to patients that have coverage issues or denials from claims.
- Responsible for providing accurate and complete data around communications with patients and notations in accounts.
- Tracks and follows up on patients with large balances and the refunds that are processed.

Performance Management
- Resolves claims issues for denied claims in a timely manner.
- Runs reports weekly on Visit Owners to help track productivity.
- Able to accurately work and manage Visit Owners in practice management system efficiently.
- Works Credits daily to ensure credit balances are decreasing.
- Identifies issues that lead to credit balances to inform operations on challenges in order to mitigate issues going forward.

Patient Focus
- Provides prompt, efficient and personalized assistance to meet the requirements, requests, and coverage assistance of patients.
- Identifies patient coverage challenges and works to resolve issues to resubmit claims or provide refunds to patient and insurances.
- Identifies and processes credit balance refunds in a timely manner.

Workplace Computers and Equipment
- Handle telephone and written inquiries.
- Enter information into Patient Management System (PM) and EMR.
- Manage Visit Owners in PM

Compliance Quality & Policy
- Maintains patient confidentiality
- Complies with federal and local patient privacy (HIPPA) laws.
- Verifies patient and or/guardian identification.
- Documents services by initiating appropriate forms, entering client data into the EMR and ensuring all documentation is appropriately signed and dated.

Teamwork
- Assists in coverage for other tasks assigned by manager.
- Performs other tasks as needed.
- Maintains open relationships and lines of communication with team members.
- Present ideas and suggestions when opportunities for improvement in workflow are identified.
- Works closely with staff on the Revenue Cycle to assist and provide feedback for a cohesive team.

Checking, Examining, and Recording
- Verify eligibility, coverage, and benefits for any claim denials.
- Research Credit Balances and issues refunds to patients and insurance carriers.
- Provides reporting on Visit Owners to review balances.
- Processes patient refunds in accordance with organization’s processes and procedures
- Detects and corrects errors, completes forms, obtains needed information and maintains logs and files.

Willingness to Learn
- Maintains knowledge of insurance information as it relates to patient accounts.
- Participates in internal and external training opportunities

SKILLS AND ABILITIES
- Must possess excellent interpersonal skills
- Knowledge of medical terminology preferred
- Basic understanding of HIPAA and PHI
- Must have good time management skills, be organized, self-motivated
- Possess excellent written and verbal communication skills
- Maintain a high level of productivity and confidentiality
- Work well in a team environment.
- Can enter data with ability to check accuracy of detail work such as correct spelling of names, numbers, dates and times.
- Ability to handle multiple tasks at once without mistakes or diminution of professional demeanor and customer service.
- Effectively able to prioritize and maintain workflow.
- Ability to function in a high volume, multiple task environments, possibly in a closely shared workspace.
- Demonstrate self motivation and the ability to work with a high degree of independence.
- Ability to effectively and efficiently solve problems as presented in real time.
- Strong organizational and task prioritization skills.

EDUCATION AND/OR EXPERIENCE:
Required: High school, G.E.D. or equivalent.

Desired: One year of customer service experience and coverage verification experience.

Desired: Bilingual

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