Accounts Resolution Specialist II

Penn Medicine; Radnor (Delaware County); On-site; USD 60,000 - 75,000; Full time

Job summary

Penn Medicine in Radnor, PA seeks an Accounts Resolution Specialist II to manage patient accounts transferred from the PBO. The role focuses on investigating claim edits, following up on denials and underpayments, and providing insight into denial trends to improve reprocessing and front-end edits.

You will act as a subject matter expert, escalate issues when needed, and may assist with training and mentoring staff in the billing group within CPUP.

Qualifications

• H.S. Diploma/GED (Required)
• 5+ years' work experience in Patient Access, Revenue Cycle, or Patient Accounting/Billing (Required)

Responsibilities

• Serves as first point of contact for addressing more complex account issues, patient concerns, and billing and insurance questions
• Utilize and work the self-pay report, denials report, and AR report
• Responsible for patient account research in relation to working accounts within the claim edit work queue and follow-up work queue
• Identify untimely accounts and performs accurate and timely write offs adhering to policy guidelines
• Responsible for maintaining the highest level of billing standards following current guidelines from Medicare, Medicaid, and other insurance entities
• Meets or exceeds established performance targets (productivity and quality) established by the Supervisor of Billing

Education

H.S. Diploma/GED

Job description

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Entity: Clinical Practices of the University of Pennsylvania (CPUP)

Department: Oral Surgery

Location: Radnor, PA

Hours: Full-Time

Summary:

• The Accounts Resolution Specialist II reports to the Supervisor of Billing; this individual specializes in the resolution of patient accounts transferred from the PBO. This position will investigate and follow up on claim edits and work denials and underpayments by insurance carriers regarding open balance to obtain payment. Act as a subject matter expert escalated issues and provide insight on identified denial trends or root cause of denials to mitigate future denials, expedite the reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate a first pass resolution. They may assist with training and mentoring other staff members according to the organization's training program.

Responsibilities:

• Serves as first point of contact for addressing more complex account issues, patient concerns, and billing and insurance questions

• Utilize and work the self-pay report, denials report, and AR report

• Responsible for patient account research in relation to working accounts within the claim edit work queue and follow-up work queue

• Identify untimely accounts and performs accurate and timely write offs adhering to policy guidelines

• Responsible for maintaining the highest level of billing standards following current guidelines from Medicare, Medicaid, and other insurance entities

• Meets or exceeds established performance targets (productivity and quality) established by the Supervisor of Billing

Education or Equivalent Experience:

• H.S. Diploma/GED (Required)

• 5+ years' work experience in Patient Access, Revenue Cycle, or Patient Accounting/Billing (Required)

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.