Patient Account Specialist Senior

Job Description

Job Description

Responsibilities

Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction is essential. Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and BD inventory.

Responsibilities : Meets expectations of the applicable OneCHRISTUS Competencies : Leader of Self, Leader of Others, or Leader of Leaders. Provides effective collection services, ensuring the successful recovery of accounts in accordance with client and state guidelines as well as TLRA’s business objectives.&

Requirements

Collections – Insurance

• Collects balances due from commercial and / or governmental insurance and third-party payers ensuring proper reimbursement for all services.
• Identifies denied or underpaid claims and dedicates efforts to ensure proper resolution and timely turnaround within payer guidelines.
• Maintains active, working knowledge of payer claims processing and appeal procedures, provider contracts with insurances and third-party payers, and different payment methodologies.
• Demonstrates knowledge of standard bill forms and filing requirements, explanation of benefits, and online payor portals and resources.
• Identifies and communicates issues and trends impacting account resolution and reimbursement.

Experience working within a multi-facility hospital business office environment. Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms.