Patient Accounts Specialist I - Physicians' Billing

MedStar Health is seeking an experienced Patient Accounts Specialist to join our revenue cycle team supporting our physicians' billing services.

The ideal candidate will have at least two years of experience in hospital or physician patient accounts and collections within medical billing operations. They must also have a strong understanding of denial resolution and appeals processing to ensure timely and accurate reimbursement.

In this role you will perform accounts receivable follow-up/collection procedures to obtain timely reimbursement from third party carriers and other payment sources on insurance invoice balances. 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 timely manner. Assists in evaluation of accounts receivable and participate in development of collection strategies to decrease outstanding balances.

MedStar Health is a great place to work and grow your career. We provide a supportive and inclusive work environment, comprehensive health and wellness benefits, generous paid time off, tuition assistance, retirement plans, and many other benefits focused on your wellbeing.

Primary Duties and Responsibilities

• Assists in maintaining integrity of the accounts receivable system database by reviewing data input for completeness and accuracy - including updating account information and transferring charges to correct financial class.
• Collects and determines follow-up needed on outstanding accounts receivable with an invoice balance less than or equal to $3000.
• Follows appeal procedures for denied claims and reimbursement below contractual fee schedule.
• Identifies patient/third party carrier complaints, resolves and communicates these complaints to management.
• In accordance with operational policies and procedures makes adjustment to patient accounts as necessary to facilitate timely reimbursement.
• Meets the Performance ETM Production quota set at 100% of the established quota.
• Monitors assigned accounts receivable categories until payments are received and posted.
• Obtains necessary billing/appeal information from provider/division/electronic record/billing contact/patient to facilitate timely claim/appeal adjudication. Provides supporting documentation at time of claim appeal to facilitate timely reimbursement.

Minimal Qualifications
Education

• High School Diploma or GED required; some college preferred
• Consideration will be given to an appropriate combination of education/training and experience.

Experience

• 2 years collection experience in medical billing operations required
• Experience and proficiency using an automated billing system GE IDX and ETM experience preferred

Knowledge Skills and Abilities

• Knowledge of ICD9/10 and CPT4 coding as it relates to third party carrier reimbursement.
• Knowledge of federal state and local legal and regulatory provisions that relate to collection activities.
• Knowledge of third-party carrier operating procedures and practices -- particularly as they relate to levels and methods of reimbursement.
• Proven skill in defining problems, collecting data, and interpreting billing information.
• Excellent organizational and analytical skills that ensure successful and accurate completion of daily quota driven processing.