Patient Accounts Specialist II - Physicians Billing

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

Candidates must have at least four years of experience in accounts receivable follow-up/collection procedures. 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

• Actively and continuously improves work processes for self. Uses continuous improvement tools and methods to improve individual team and cross-departmental performance. Bases improvements on customer requirements data root-cause analysis and outcomes.
• Assists in the planning of work for self and Insurance Specialist including setting goals prioritizing work and coordinating the execution of work. Assists supervisor in planning coordinating and direction of daily work activities of clerical billing and collection staff. Assists supervision in collection activities and functions.
• Assists with determining organization processes that maximize cash receipts.
• Bills patient accounts and assures accuracy by reviewing and verifying patient charges coordinating benefit level type of coverage and/or approval for coverage.
• Collects insurance accounts by contacting insurance carriers and other third party payers to verify receipt of billing and other information needed to process claims secure approximate date of payment negotiate with claims personnel for prompt payment and resolve discrepancies in billings within appropriate time frames.
• Develops productive relationships with payer representatives to secure timely payment of claims.
• Forwards bill to third party payers and/or enters billing information into computerized billing system.
• Interprets data and reports to determine work priorities and resource allocation across multiple billing and collection tasks.
• Investigates and resolves insurance claim rejections.
• Meets the Performance ETM Production quota set at 90% of the established quota.
• Reviews and monitors work quantity and quality recommends the allocation of resources helping to ensure departmental goals are met or exceeded.

Minimal Qualifications
Education

• High School Diploma or GED required
• Associate's degree or Bachelor's degree

Experience

• 4 years of progressively responsible experience in hospital/physician patient accounts or equivalent experience required
• Experience and proficiency using an automated billing system GE IDX and ETM experience

Knowledge Skills and Abilities

• Effective negotiating skills to include ability to resolve complex billing and collection situations with individual patients or third party payers.
• Proactive problem solving skills.
• Ability to interpret data and related information and discern trends and tendencies as well as determine appropriate course of action.
• Ability to work as part of team set goals prioritizes work and assist in the coordination and execution of work.
• Ability to assist in the following areas: lead monitor daily activities evaluate train and motivate performance of team members.
• Effective verbal and written communication skills.
• Knowledge of ETM basic operation of hardware and work processing and spreadsheet packages preferably Microsoft.
• Knowledge of relevant billing and collection laws and regulations hospital protocols.
• Knowledge of third party claims and diagnostic coding to include ICD 9/10 and CPT coding.
• Demonstrates proven successful organizational and analytical skills that ensure consistent completion of daily quota driven processing.