Account Specialist I

TriHealth; Cincinnati (OH); On-site; USD 38,000 - 54,000; Full time

Job summary

TriHealth seeks a detail-oriented billing professional to expedite positive cash flow by accurate, timely billing, follow-up, and collections of patient accounts. You will handle follow-ups on balances, process accounts daily per payer requirements, and contact payers and patients regarding payments.

Strong customer service and knowledge of government and non-government billing is required. The role involves working with internal teams to resolve discrepancies, prepare status reports, and reduce

Qualifications

• High School Degree required.
• Proficient in EDI/PC applications.
• 1-2 years experience in a related field.

Responsibilities

• Collects insurance and self-pay dollars outstanding through interactions with payers and patients.
• Responds to inquiries from customers and insurance companies; works insurance denials to identify errors and resubmit claims.
• Prepares monthly status reports for senior management and reduces outstanding accounts receivable.

Skills

EDI

Accounts receivable

Customer service

Education

High School Diploma or GED

Tools

EDI software

Job description

Job Overview

The major purpose of this position is to expedite positive cash flow, maximize reimbursement, and reduce or eliminate financial loss to department customers by accurate efficient timely billing, follow-up and collections of patient accounts. Duties include: In charge of the timely and accurate follow-up on all patient account balances; In charge of processing the specified number of accounts on a daily basis based on customer specialty and unique billing requirements; In charge of understanding both Government & Non Government Contractual billing and Follow-up guidelines, based on individual payers; Responsible for contacting Government, Non Government & Self payers regarding lack of payment or improper payment; Resolves all incorrect payment issues and ensures that balances after insurance payments are correct based on contracts with individual payers; Displays quality customer service to internal/external customers, by providing timely/accurate information, and works to ensure that problems are resolved.

Job Requirements

• High School Degree
• Proficient in EDI/PC applications
• 1-2 years experience in a related field

Job Responsibilities

Collects insurance and self-pay dollars outstanding through interactions with payers and patients. Participates willingly in payer communications and supports other in sharing information and keeping others up to date. Prepares monthly status reports for submission to senior management. Reduce the outstanding accounts receivable associated with each assigned customer book of business as measured by cash collections and days in accounts receivable.

Responds to written and oral inquiries from customer contacts and insurance companies. Works insurance denials on a daily basis in order to identify errors, correct errors and resubmit claims for payment. Looks for trends and tracks statistics.

Other job-related information

Working Conditions

• Climbing - Rarely
• Hearing: Conversation - Consistently
• Hearing: Other Sounds - Frequently
• Kneeling - Occasionally
• Lifting 50+ Lbs. - Rarely
• Lifting <50 Lbs. - Occasionally
• Pulling - Rarely
• Pushing - Occasionally
• Reaching - Rarely
• Sitting - Consistently
• Standing - Rarely
• Stooping - Occasionally
• Talking - Consistently
• Use of Hands - Consistently
• Color Vision - Occasionally
• Visual Acuity: Far - Frequently
• Visual Acuity: Near - Consistently
• Walking - Frequently

TriHealth SERVE Standards and ALWAYS Behaviors

At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:

Serve: ALWAYS

• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas

Excel: ALWAYS

• Recognize and take personal responsibility to address and recover from service breakdowns when a customer’s expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service

Respect: ALWAYS

• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone’s opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.

Value: ALWAYS

• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.

Engage: ALWAYS

• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community