Patient Accounts Specialist II - Physicians' Billing

Patient Accounts Specialist (Level II)

MedStar Physicians' Billing Services has an opening for an experienced Patient Accounts Specialist (Level II) to join our team and work remote from home! To be successful, candidates must have a minimum of four years of experience in hospital / physician patient accounts and collections in medical billing operations. Join one of the largest health systems in the Maryland, Virginia, and Washington, D.C., area and enjoy the benefits of a full benefits package including paid time off, health / vision / dental insurance, short- & long-term disability, tuition reimbursement, and the benefits of remote work capability.

Job Summary - Under general supervision, performs accounts receivable follow-up / collection procedures to obtain timely reimbursement from third party carriers and other payment sources on moderately complicated invoices in a Direct Contract assignment and / or with an invoice balance. Performs collection activity for assigned divisions, third party carriers, and individual providers. Maintains contacts with third party carriers and communicates billing / reimbursement changes to management in a timely manner. Assists in evaluation of A / R and participate in development of collection strategies to decrease outstanding A / R.

Primary Duties and Responsibilities

• Actively and continuously improves work processes for self. Uses continuous improvement tools and methods to improve individual, team, and cross-departmental performance. Bases improvements on customer requirements, data, root-cause analysis, and outcomes.
• Assists in creation / implementation of in service training materials and presentation for team development.
• Assists in the planning of work for self and Insurance Specialist, including setting goals, prioritizing work, and coordinating the execution of work. Assists supervisor in planning, coordinating, and direction of daily work activities of clerical, billing, and collection staff. Assists supervision in collection activities and functions.
• Assists with determining organization processes that maximize cash receipts.
• Bills patient accounts and assures accuracy by reviewing and verifying patient charges, coordinating benefit level, type of coverage, and / or approval for coverage.
• Collects insurance accounts by contacting insurance carriers and other third party payers to verify receipt of billing and other information needed to process claims, secure approximate date of payment, negotiate with claims personnel for prompt payment, and resolve discrepancies in billings within appropriate time frames.
• Communicates effectively with staff at all levels of organization, both inter and intra-departmentally.
• Contacts and participates in meetings with internal and external customers to resolve difficulty payment or process issues.
• Develops productive relationships with payer representatives to secure timely payment of claims.
• Forwards bill to third party payers, and / or enters billing information into computerized billing system.
• Interprets data and reports to determine work priorities and resource allocation across multiple billing and collection tasks.
• Investigates and resolves insurance claim rejections.
• Meets the Performance ETM Production quota set at 90% of the established quota.
• Participates in educational / professional development activities. Exemplifies Guest and Staff Relations standards in all activities in areas of service, resource utilization, high quality outcomes, and effective communication. Provides guidance and instruction to fellow team members when necessary.
• Provides information regarding work progress, actions, and issues in a timely and effective manner. Recommends improvements.
• Recommends timely invoice adjustments.
• Reviews and monitors work quantity and quality, recommends the allocation of resources, helping to ensure departmental goals are met or exceeded.
• CUSTOM.PRIMARY.DUTIES.RESPONSIBILITIES.ADDENDUM

Minimum Qualifications

Education

Experience

Knowledge, Skills, and Abilities

This position has a hiring range of $20.17 - $35.04