Patient Accounts Specialist

4 weeks ago


Manchester, New Hampshire, United States Catholic Medical Center Full time

Job Summary:
Catholic Medical Center is seeking a skilled Patient Accounts Representative to join our team. As a key member of our billing department, you will be responsible for accurate billing of hospital and/or professional accounts, ensuring timely claim submission, reimbursement from various third-party payers, and proper account documentation. This is a benefitted full-time role with a bonus opportunity and a hybrid work arrangement offering 2 days of remote work after training.

Key Responsibilities:
Work daily electronic billing work queues and paper claims submission by resolving payer edits and mailing/releasing claims to the clearing house or third-party payers.
Document billing activity on the account; ensure compliance with all applicable billing regulations for assigned payers and report any suspected/questionable compliance/billing concerns to the attention of department leaders.
Review and correct all claim denials that are communicated via Explanation of Benefits (EOB), denial reports, denial management system, or correspondence from the insurance carrier or others to determine what follow-up action is necessary, including initiating the adjustment or appeals process if needed.
Review and process all required daily reporting activities, including late charges, diagnosis changes, charge corrections, and initiate corrected bills to the payer as needed.
Determine proper disposition of credit balances and take-backs (from payers) on accounts and initiate refunds, adjustments, or corrected claims.
Monitor claim rejections for trends and issues, report these findings to the team lead/manager to reduce future claim rejections.
Perform follow-up on unresolved open accounts and document all reasons for reimbursement delays as well as actions taken within the electronic billing system.
Monitor workload for aging inventories and timely filing.
Practice excellent customer service skills by answering patient, internal associates, and third-party questions and/or addressing billing concerns in a timely, professional, and efficient manner.

Qualifications:
High school diploma or equivalent required; Associates degree preferred.
Minimum of 1-2 years of medical billing experience in a healthcare setting preferred.
Knowledge of basic patient accounting processes and healthcare terminology strongly preferred.

About Us:
Catholic Medical Center is a nonprofit, regional health system committed to delivering the highest quality and most advanced healthcare to patients across New Hampshire. We are driven by our mission to offer health, healing, and hope to every individual who seeks our care, and we live by our values of Respect, Integrity, Compassion, and Commitment. We are proud to be named to the Forbes list of America's Best-in-State Employers for two consecutive years.



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