Patient Accounts Specialist I - Governmental Team

Patient Accounts Specialist

MedStar's Patient Financial Services is currently seeking a Patient Accounts Specialist to join our Governmental Team. Candidates must have at least one year of related patient accounting follow-up experience (experience with facility or physician claims follow-up, researching claim denials and preparing / writing appeals to get claims paid). Position requires on-site training in Nottingham, Maryland (up to the first 90-days). The Governmental Team is responsible for the billing and follow up of claims for our governmental insurance plans. The Governmental Plans include a variety of payers such as Tricare, Tricare for Life, ChampVA, Veterans Administration, Optum VACCN and Medicare. Claims are billed via UB04. Interprets and evaluates appeals to include follow-up with payers to assure timely turn around for claims resolution and reimbursement. Must be able to interpret explanation of benefits and have a clear understanding of payer methodology. Works in a team environment.

Primary Duties and Responsibilities :

• Keeps abreast of regulatory and specific changes as it relates to billing requirements and payer specific follow up.
• Maintains daily performance benchmarks as it applies to interpreting and evaluating appeals to include follow up with payers. Completes coding report updates within the standard set in a timely manner to begin the daily workflow process. Responsible for reconciliation of reports to SMS and information that was posted.
• Maintains departmental QA standard within established error rate.
• Meets team specific benchmark as it applies to completed Tracking Forms forwarded to the Operational Desk after completion on a daily basis, >

$10K, >

$20K, AR15, AR30, and AR45.

Minimum Qualifications :

Education :

Experience :

Knowledge, Skills, and Abilities :

This position has a hiring range of $18.70 - $32.72