Orthopedic Institute Patient Account Specialist

2 days ago

Sioux Falls, South Dakota, United States Orthopedic Institute Full time
Job Summary

This role is responsible for ensuring timely and accurate processing of patient accounts with third-party payers. The ideal candidate will possess excellent communication skills, attention to detail, and the ability to work effectively in a fast-paced environment.

Key Responsibilities
  • Responsible for resubmitting primary, secondary, and tertiary claims in accordance with regulatory requirements and payer policies.
  • Communicate with third-party representatives to complete claims processing and resolve problem claims.
  • Follow up daily on post-processing activity, including rejected billings, adjustments, and rebilling, for accounts greater than 30 days old.
  • Maintain accurate and up-to-date accounts receivable detail using online system documentation.
  • Meet or exceed collection goals by payer each month.
  • Work all assigned accounts at least once every 15 or 30 days, depending on balance.
  • Participate in educational activities and attend monthly department staff meetings.
  • Maintain confidentiality and adhere to all HIPAA guidelines and regulations.
Requirements
  • High School diploma or General Education Degree.
  • Three to Five years' experience in medical office billing preferred.
  • Knowledge of ICD-10/HCPCS/CPT coding.
  • Basic knowledge of third-party insurance plans.
  • Familiarity with medical terminology helpful.
Skills
  • Effective communication skills when interacting with insurance carriers, third-party payers, and patients.
  • Ability to learn and understand patient accounting policies and procedures and the Accounts Receivable computer system.
  • Intermediate knowledge of Microsoft Word and Excel, and the ability to learn innovative programs and systems.
  • Dependable in both production and attendance.

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