Patient Accounts Specialist I - Follow-up Team

General Summary of PositionMedStar Patient Financial Services Non-Government South Follow-up Team is currently seeking an experienced Patient Accounts Specialist to join our amazing team. We are specifically looking for a candidate that has experience with facility and/or physician claims follow-up, researching claim denials and preparing/writing appeals to get claims paid.Position is remote with full-time, flexible Monday – Friday, day shift schedule.The Non-Governmental Follow-Up South Department works all Commercial, HMO, MCO, Medicare Advantage and Workers’ Comp payers for the two DC MedStar Health hospitals. The team does “follow up” on accounts that have been billed and no payment has been received or when only partial payment is received. The team issues written appeals for denials. The DC facilities work off a contract-based reimbursement system, so all South team members are familiar with all the contracts for each payer for each facility. To make it more manageable, each team member has a dedicated payer or group of payers, depending on the volume that they work. Team members are cross trained as needed.Job Summary - Interprets and evaluates appeals to include follow-up with payers to assure timely turn around for claims resolution and reimbursement. Must be able 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.• Participates in PFS workgroups, staff meetings and work events.• Participates in multi-disciplinary quality and service improvement teams.• Meets monthly departmental key performance indicators (KPIs) as it applies to open receivable, aged AR, credit balances, and high dollar accounts.Minimum QualificationsEducation• High School Diploma or GED equivalent requiredExperience• 1-2 years experience in patient accounting, accounts receivable or related healthcare field required• An equivalent combination of experience and college education in accounting, finance or healthcare administration requiredKnowledge, Skills, and Abilities• Detailed working knowledge and demonstrated proficiency in at least one specific payers application billing and/or collection process.• Requires basic working knowledge of UB04 and Explanation of Benefits (EOB).• Requires some knowledge of medical terminology and CPT/ICD-9/10 coding.• Excellent communication, analytical, interpersonal, and organizational skills.• Proficient uses of hospital registration and/or billing systems and personal computers as well as Microsoft Excel and Word applications.• Ability to type 35 WPM.This position has a hiring range of $18.33 - $29.96