Location: New York
The Patient Accounts Specialist researches patient and staff questions about accounts and makes appropriate adjustments. Reconciles and resolves open accounts. In addition, audits and posts charges and payments to patient accounts. Minimum Qualifications Knowledge, Skills & Abilities
- Reads, speaks, understands and writes proficiently in English.
- Independent and self-directed.
- Works effectively in a team environment.
- Problem-solves with creativity and ingenuity.
- Organizes, prioritizes, and coordinates multiple activities and tasks.
- Works with initiative, energy and effectiveness in a fast-paced environment.
- Produces work in high quantity and quality.
- Remains calm and effective in high pressure and emergency situations.
- Use of multi-line telephones and other office machines.
- 10-Key: 150 kpm with a 97% accuracy rate.
- Knowledge of medical terminology.
- Proficiency in the use of Microsoft Office applications; Word, Excel and Outlook.
- Knowledge of dental terminology.
- Bilingual skills.
- High school graduate or equivalent.
- Graduate of an accredited Medical Billing Certificate program.
- Customer service related experience working with the general public (1 year).
- ICD-10 coding experience (1 year).
- CPT-4 coding experience (1 year).
- Data entry experience (1 year).
- Working with insurance/billing in a healthcare setting.
- Healthcare information systems, such as electronic health record and practice management systems experience (1 year).
- Working with private and/or government third party reimbursement.
- CDT-5 coding experience.
- Working with low income, multi-ethnic populations.
- Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) or Coding Specialist (CCS) certified by the American Health Information Management Association (AHIMA).
Job Specific Functions/Performance Expectations:
1. Verifies insurance coverage and submits claims to insurance companies.
2. Bills primary insurances.
3. Verifies proper CPT and diagnosis coding is entered in the practice management system based on the level of service provided and documented in the electronic health record by provider.
4. Assists patients in setting up payment plans and completes payment plan contracts.
5. Posts daily charges submitted from electronic health record and audit their accuracy.
6. Processes daily reports to clinics of electronic charge entry corrections and tracks their return.
7. Adheres to quality and quantity standards of the department, which includes but is not limited to a minimum of 97% accuracy on quality of work and the ability to review, code, and bill 30 claims per hour.
8. Be a resource for staff on all aspects of insurance programs, discounts applications and, provider coding, payment plans and patient payment processing.
9. Performs A/R resolution.
10. Processes discount fee adjustments and enters tracking data into discount fee database.
11. Assists patients in completing applications and qualifying for discount fee program.
12. Scans various documents, including but not limited to statement verifications, collections, OB billing and invoices.
13. Researches patient questions regarding accounts/statements and initiates appropriate adjustments and/or resubmission of claim(s).
14. Researches and reconciles patient credit balances and initiates refund requests.
15. Adheres to the department?s standards of personal phone use.
16. Adheres to attendance standards in order to perform the job functions for daily operations and/or continuity of patient care.