Account Specialist Ambulatory F/T Day
1 month ago
Inspire health. Serve with compassion. Be the difference.
Job Summary
Responsible for processing insurance claims. Coordinates collections and delinquent unpaid accounts. Oversees claim processing. Investigates billing problems and assists with error resolution.Accountabilities
INSURANCE RESPONSIBILITIES:
A. Assists in the processing of insurance claims including Medicaid/Medicare claims.
B. Collects and enters patient's insurance information into database.
C. Assists patients in completing all necessary forms. Answers patient questions and concerns.
D. Reviews and verifies insurance claims. Requests refunds when appropriate.
E. Processes Medicare correspondence, signature, and insurance forms.
F. Follows-up with insurance companies and ensures claims are paid within timeframes as outlined in MA policies and procedures.
G. Resubmits insurance claims that have received no response.
H. Answers telephone, screens calls, takes messages, and provides information.
I. Maintains files with referral slips, Medicare authorizations, and insurance slips.COLLECTION RESPONSIBILITIES:
A. Identifies delinquent accounts, aging period and payment sources. Processes delinquent unpaid accounts by contacting patients and third party reimbursers.
B. Reviews each account, credit reports and other information sources such as credit bureaus via computer.
C. Performs various collection actions including contacting patients by phone and resubmitting claims to third party reimbursers.
D. Evaluates patient financial status and establishes budget payment plans. Follows and reports status of delinquent accounts.
E. Reviews accounts for possible assignment makes recommendation to Credit Manager and prepares information for collection agency.
F. Assigns uncollectible accounts to collection agency or attorney via clinic Credit and Collection policy. Contacts lawyers involved in third-party litigation.
G. Answers inquiries and correspondence from patients and insurance companies. Develops collection letters.
H. Identifies and resolves patient billing complaints. Researches credit balances.CLAIMS RESPONSIBILITIES:
A. Oversees claim processing and payments to third party providers. Answers associated correspondence.
B. Monitors charges and verifies correct payment of claims and capitation deductions.
C. Sends denial letters on claims and follow-up on requests for information.
D. Audits and reviews claim payments reports for accuracy and compliance.
E. Researches and resolves claim and capitation problems.
F. Maintains timely provider information in physician files.
G. Maintains insurance company manual and distributes information to staff on updates and changes.
H. Maintains required databases and patients accounts, reports and files.
I. Resolves misdirected payments and returns incorrect payments to sender.
J. Answers patients inquires regarding account balances.
K. Appeals denied claims adhering to payer policy while communicating with MAMC department for further assistance with claims resolution as appropriate.
L. Works all assigned claims within designated time frame to ensure timely and appropriate paymentBILLING RESPONSIBILITES:
A. Researches all information needed to complete billing process including getting charge information from physicians.
B. Works with other staff to follow-up on accounts until zero balance or turned over for collection.
C. Assists with coding and error resolution.
D. Maintains required billing records, reports, and files.
E. Investigates billing problems and formulates solutions. Verifies and maintains adjustment records.
F. Maintains and enhances current knowledge of assigned payers with regard to guidelines for billing
G. Provides training to front office staff when hired and retraining as needed or requested with regard to a specific payer rules and guidelines for physician billing.
H. Recommends changes to departmental processes as necessary to maximize operational effectiveness of the revenue cycle.
MISCELLANEOUS:
1. Maintains strictest confidentiality.
2. Participates in educational activities.
3. Performs related work as required.
4. As representative of Prisma Health Clinical Department, is expected to maintain neat and professional appearance, demonstrate commitment to serve at all times and uphold guidelines set forth in office manual.Supervisory/Management Responsibility
This is a non-management job that will report to a supervisor, manager, director, or executive.
Minimum Requirements
High School diploma or equivalent 2 years of experience in billing, bookkeeping, collections or customer service.Required Certifications/Registrations/Licenses
N/A
In Lieu Of The Above Minimum Requirements
N/A
Other Required Skills and Experience
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 experienceWork Shift
Day (United States of America)Location
Patewood Outpt Ctr/Med OfficesFacility
2127 Geriatric LTCDepartment
21271000 Geriatric LTC-Practice OperationsShare your talent with us Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
-
PATIENT SERVICES REPRESENTATIVE F/T DAY
1 week ago
Greenville, SC 29617, USA, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference.Job SummaryIncumbents are responsible for aspects of Physician Practice front office management and operation as assigned. May be responsible for some or all front office functions as detailed in the next section.Accountabilities* Responsible for complete and accurate patient registration,...
-
PATIENT SERVICES REPRESENTATIVE F/T DAY
1 week ago
Greenville, SC 29617, USA, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference.Job SummaryIncumbents are responsible for aspects of Physician Practice front office management and operation as assigned. May be responsible for some or all front office functions as detailed in the next section.Accountabilities* Responsible for complete and accurate patient registration,...
-
PATIENT SERVICES REPRESENTATIVE F/T DAYS
1 week ago
Greenville, SC 29617, USA, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference.Job SummaryIncumbents are responsible for aspects of Physician Practice front office management and operation as assigned. May be responsible for some or all front office functions as detailed in the next section.Accountabilities* Responsible for complete and accurate patient registration,...
-
PATIENT ACCESS SPECIALIST F/T DAY
1 week ago
Greenville, SC 29617, USA, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference.Job SummaryReceives and interviews patients to collect and verify pertinent demographic and financial data. Verifies insurance and initiates pre-authorization process when required. Collects required payments or makes necessary financial arrangements. Performs all assigned duties in a courteous and...
-
PATIENT SERVICES REPRESENTATIVE F/T DAY
1 week ago
Greenville, SC 29617, USA, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference.Job SummaryIncumbents are responsible for aspects of Physician Practice front office management and operation as assigned. May be responsible for some or all front office functions as detailed in the next section.Accountabilities* Responsible for complete and accurate patient registration,...
-
Specialist, Account Marketing
4 weeks ago
Greenville, South Carolina, United States International Vitamin Corporation Full timeOverview: International Vitamin Corporation (IVC) is a leading global manufacturer of vitamins and nutritional supplements with more than half a century of private label and contract manufacturing experience, an impeccable quality and regulatory compliance record, and with new resources focused on enriching the health and lives of others. This role is a key...
-
Relocation Specialist
2 days ago
Greenville, United States Caring Transitions Full timeJob DescriptionJob DescriptionJoin Caring Transitions of Madison and West Bond County as a Relocation Specialist servicing the majority of the Metro East St. Louis area in Illinois. Step into a role where every day is filled with opportunities to make a positive impact while having fun along the way! As part of our dynamic team, you'll find a workplace...
-
Specialist
3 weeks ago
East Greenville, United States MillerKnoll, Inc. Full timeWhy join us? Knoll uses modern design to connect people to their work, their lives, their world. Since 1938, we have been recognized internationally for creating workplace and residential furnishings that inspire, evolve, and endure. Our purpose is t Specialist, Manufacturing, Healthcare
-
Health Savings Account Client Service Specialist
2 weeks ago
Greenville, United States McGriff Insurance Broker Full timeAs a member of the Retail HSA product servicing team, this role would provide support to clients and internal customers relevant to product education, troubleshooting issues relevant to servicing issues, and service desk responses to clients relevant Client Service, Health, Specialist, Account, Service, Retail, Insurance, Client
-
Registered Nurse
4 days ago
Greenville, SC, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference. Job Summary Provides routine, standardized nursing care for patients under the supervision of the physician. This job requires regional travel across all Prisma Health sites. Accountabilities * Assists physicians with examinations, procedures and other activities related to direct patient care. -...
-
Tax and Accounting Manager
1 week ago
Greenville, United States Wilson James Full timeJob DescriptionJob DescriptionA growing CPA and Financial Planning practice is looking for an experienced Tax and Accounting Manager to add to their team!This is a fantastic opportunity if you are looking for somewhere that provides autonomy, growth potential, a voice as a leader, and the opportunity to in effect lead an office of the firm. This could also...
-
Greenville, South Carolina, United States Moonlighting Solutions Full timeAre you looking for a short-term GI moonlighting opportunity with competitive pay? We are looking for gastroenterologists to cover weekday outpatient clinic shifts for 6+ months in Eastern North CarolinaPosition Details: Mon-Fri or M/W/F schedule 8am5pm Ambulatory clinic only (No call, no ICU or backup ER coverage) New patient consults & followups, 1520...
-
Licensed Practical Nurse
1 day ago
Greenville, SC, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference. Job Summary Provides routine, standardized nursing care for patients under the supervision of the physician. This job requires regional travel across all Prisma Health sites. Accountabilities * Assists physicians with examinations, procedures and other activities related to direct patient...
-
Patient Advocate Non-Clinical, GMMC, FT, Day
5 days ago
Greenville, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference. Job Summary The Patient Advocate represents Prisma Health with patients, families, and visitors in responding to concerns and providing service recovery. Partners with patient safety, quality and risk management to address more clinically focused concerns. Coordinates the resolution of complaints and...
-
Fleet Service Specialist
2 days ago
Greenville, United States Hyster-Yale Group Full timeJob Title Fleet Service Specialist Job Family Job Description Put a LIFT in Your Career! Hyster-Yale Group, Inc. (HYG), a world-class manufacturer of industrial lift trucks, has an outstanding opportunity for an exceptional and talented Fleet Services Specialist at our facility located in Greenville, NC. HYG designs, engineers, manufactures, sells and...
-
REGISTERED NURSE
3 weeks ago
Greenville, NC 27833, USA, United States Vidant Health Full timeJob DescriptionECU HealthAt the James and Connie Maynard Children's Hospital, located at ECU Health Medical Center in Greenville, we are committed to caring for the kids of eastern North Carolina. As the region's only Children's Hospital, this hospital within a hospital has a total 197 beds and bassinets, including a Level IV NICU, quaternary PICU with ECMO...
-
Registered Nurse
4 days ago
Greenville, SC, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference. Job Summary Provides clinical direction for all aspects of patient care in an ambulatory setting under the direction of the physician, Advanced practice provider, or physician resident. Demonstrates clinical competency utilizing evidence based practices/research in all areas of the nursing process:...
-
Accounting Support Specialist
4 weeks ago
Greenville, United States INDUSTRIAL PACKAGING SUPPLIES INC Full timeJob DescriptionJob DescriptionAbout Us:Founded in 1976, IPS Packaging & Automation is a family-owned and operated business that specializes in supplying our customers with comprehensive packaging solutions. With 48 years of experience in the industry, we are a nationwide leader in packaging products, equipment, and service.Position Summary: The Receptionist...
-
Greenville, South Carolina, United States Prisma Health Full timeInspire health. Serve with compassion. Be the difference.Job SummaryProvides routine, standardized nursing care for patients under the supervision of the physician.1) Assists physicians with examinations, procedures and other activities related to direct patient care. 20% 2) Arranges for patient appointments for diagnostic testing, consults, referrals and...
-
Fleet Service Specialist
7 days ago
Greenville, United States Hyster-Yale Materials Handling Full timeJob Title Fleet Service Specialist Job Family Job Description Put a LIFT in Your Career! Hyster-Yale Group, Inc. (HYG), a world-class manufacturer of industrial lift trucks, has an outstanding opportunity for an exceptional and talented Fleet Services Specialist at our facility located in Greenville, NC. HYG designs, engineers, manufactures, sells and...
