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Patient Accounts Specialist

1 month ago

Jacksonville, Florida, United States Mental Health Resource Center Full time
Job Summary

The Patient Accounts Specialist is responsible for accurate and timely claims submissions, reimbursements, adjustments, and refunds of assigned insurance payers in accordance with current policies and procedures.

Responsibilities
  • Files claim with all appropriate payers.
  • Generates daily billing reports that reflect payer summaries of claims filed and amounts to be collected for submission to the Business Office Manager.
  • Transmits billing electronically and manually for all companies in accordance with departmental deadlines.
  • Performs timely and accurate applications and insurance company payments/adjustments.
  • Evaluates denials in a timely manner for appropriate reconciliation, rebilling, and other necessary follow-up.
  • Receives phone calls and inquiries from both third-party payers and individuals served on claims and responds to same as appropriate.
  • Maintains and updates financial files that contain current demographics, historical data, financial status, and payer source. Works cooperatively with other departments to obtain accurate clinical and demographic information to ensure timely billing and collection of fees owed for services rendered.
  • Works with staff on third-party verification. Coordinates with utilization management, inpatient admitting clerk, and outpatient staff to assure proper pre-certifications are obtained from insurance companies. Performs insurance verifications when necessary.
  • Reviews and utilizes Accounts Receivables aging and billing error reports for the purposes of correction, reconciliation, and problem resolution in regard to receivables, in an effort to prevent 90 and 120-day receivables.
  • Processes financial evaluations for eligibility of sliding scale, as well as maintaining financial documents.
Qualifications
  • In order to be considered, candidates must have a High school graduate or equivalent required and two years of medical third-party billing and collection experience required.
  • Two years experience working with a desktop computer and related software (i.e. Microsoft Office).
  • Experience with Medicare preferred.