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Accounts Resolution Specialist I

1 month ago

Radnor Twp, United States Pennsylvania Medicine Full time

Job Title: Accounts Resolution Specialist I Department: Oral Surgery Location: Centre Square West Tower- 1500 Market Street Hours: Full Time Summary: The Account Resolution Specialist I reports to the Supervisor of Billing; primary responsibilities are to facilitate activities necessary to a successful resolution of accounts. This position will work out of assigned work queues handling claim edit work queue resolution as well as follow up work queue denials transferred from Professional Billing Office that require department intervention. Individuals will be responsible for investigating claim denials and underpayments by insurance carriers and appeal for payment or make appropriate adjustment. Exercising good judgement in escalating identified denial trends or root cause of denials to mitigate future denials, expedite the reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate a first pass resolution. Responsibilities: Responsible for patient account research in relation to working accounts within the claim edit work queue and follow-up Identifying untimely accounts and performing accurate and timely write offs adhering to policy guidelines Responsible for maintaining the highest level of billing standards following current guidelines from Medicare, Medicaid, and other insurance entities. Answering revenue cycle patient inquiries as well as front desk questions regarding patient accounts Meets or exceeds established performance targets (productivity and quality) established by the Supervisor of Billing Performs duties in accordance with Penn Medicine and entity values, policies, and procedures Other duties as assigned to support the unit, department, entity, and health system organization Credentials: Education or Equivalent Experience: H.S. Diploma/GED (Required) 3+ years Working in health care (professional) billing, health insurance or equivalent

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