Account Specialist
7 days ago
We are seeking a highly skilled Account Specialist to join our team at Prisma Health. As an Account Specialist, you will be responsible for processing insurance claims, coordinating collections, and overseeing claim processing.
Key Responsibilities- Insurance Claims Processing
- Assist in the processing of insurance claims, including Medicaid and Medicare claims.
- Collect and enter patient insurance information into our database.
- Assist patients in completing necessary forms and answer their questions and concerns.
- Review and verify insurance claims, requesting refunds when necessary.
- Process Medicare correspondence, signatures, and insurance forms.
- Follow up with insurance companies to ensure claims are paid within designated timeframes.
- Collection and Account Management
- Identify delinquent accounts, aging periods, and payment sources.
- Process delinquent unpaid accounts by contacting patients and third-party reimbursers.
- Review each account, credit reports, and other information sources to determine the best course of action.
- Evaluate patient financial status and establish budget payment plans.
- Follow and report the status of delinquent accounts.
- Claim Processing and Payments
- Oversee claim processing and payments to third-party providers.
- Monitor charges and verify correct payment of claims and capitation deductions.
- Send denial letters on claims and follow up on requests for information.
- Audit and review claim payments reports for accuracy and compliance.
- Billing and Coding
- Research all information needed to complete the billing process, including charge information from physicians.
- Work with other staff to follow up on accounts until zero balance or turned over for collection.
- Assist with coding and error resolution.
- Maintain required billing records, reports, and files.
- Confidentiality and Professionalism
- Maintain strict confidentiality at all times.
- Participate in educational activities to enhance knowledge and skills.
- Perform related work as required.
- High School diploma or equivalent.
- 2 years of experience in billing, bookkeeping, collections, or customer service.
- Associate Degree in a technical specialty program of 18 months minimum in length (preferred).
- Multi-specialty group practice setting experience (preferred).
- Intermediate ICD-9 and CPT coding abilities (preferred).
- Electronic Claims Billing experience.
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