Accounts Resolution Specialist I - Ophth Clinical Support

Penn Medicine, University of Pennsylvania Health System; Philadelphia (Philadelphia County); On-site; USD 40,000 - 65,000; Full time

Job summary

An established industry player is seeking an Accounts Resolution Specialist I to support their Ophthalmology Clinical team. In this pivotal role, you will facilitate successful account resolutions by investigating claim denials and underpayments. Your expertise will help maintain high billing standards and ensure compliance with insurance guidelines. This position offers a chance to make a significant impact in the healthcare sector while working in a collaborative environment dedicated to excellent patient care and innovative research. If you have a passion for healthcare billing and a commitment to quality, this opportunity is perfect for you.

Benefits

Prepaid Tuition Assistance

Comprehensive Benefits

Diversity and Equal Opportunity Employment

Qualifications

• 3+ years of experience in healthcare billing or health insurance.
• High School Diploma or GED is required.

Responsibilities

• Research and resolve patient accounts related to claims.
• Maintain billing standards adhering to Medicare and Medicaid guidelines.

Skills

Healthcare Billing

Claim Denial Investigation

Patient Account Management

Insurance Guidelines Compliance

Education

High School Diploma or GED

Job description

Accounts Resolution Specialist I - Ophth Clinical Support

Join to apply for the Accounts Resolution Specialist I - Ophth Clinical Support role at Penn Medicine, University of Pennsylvania Health System.

Job Overview

Department: Ophth Clinical Support

Location: Penn Presbyterian Medical Center - 51 N 39th Street

Hours: Full Time

Job Description

The Accounts Resolution Specialist I reports to the Supervisor of Billing. The primary responsibilities include facilitating activities necessary for successful account resolution, working out of assigned work queues, investigating claim denials and underpayments, and appealing for payment or making adjustments. The role involves exercising good judgment in escalating denial trends to mitigate future issues, expediting reprocessing, and enhancing claim edits to achieve first-pass resolution.

Responsibilities

• Research patient accounts related to claim edit and follow-up work queues.
• Identify untimely accounts and perform accurate write-offs according to policy guidelines.
• Maintain high billing standards adhering to Medicare, Medicaid, and other insurance guidelines.
• Respond to revenue cycle inquiries and front desk questions regarding patient accounts.
• Meet or exceed performance targets set by the Supervisor of Billing.

Qualifications

• High School Diploma or GED (Required)
• At least 3 years of experience in healthcare billing, health insurance, or equivalent.

Additional Information

We offer comprehensive benefits, including prepaid tuition assistance. Penn Medicine is committed to diversity and equal opportunity employment. Our employees are dedicated to our mission of providing excellent patient care, conducting innovative research, and educating future medical leaders.