Patient Account Specialist - Business Services - Hybrid (On-Site Training)

Christie-Clinic; Champaign (IL); On-site; USD 42,000 - 63,000; Full time

Benefits offered by this job

Paid Time Off

401k Plan

Medical Flexible Spending Account

Health Insurance

Dental Insurance

Job summary

Christie Clinic is seeking a full-time Patient Account Specialist to manage medical claim denials and insurance communications. The role focuses on ensuring timely claim processing and maximizing reimbursement, with training and potential hybrid remote work after competency attainment.

Responsibilities include eligibility verification, charge review, post adjustments in Epic, and ongoing coordination with insurers and clinical teams.

Qualifications

• High school diploma or equivalent required.
• Medical claim denial experience required.
• Epic knowledge preferred; CPT/ICD-10-CM/HCPCS knowledge beneficial.

Responsibilities

• Verify insurance eligibility for patients through online carrier portals or telephone.
• Process charge reviews to verify CPT/diagnosis codes and dates of service; request documentation as needed.
• Post adjustments and remark codes in Epic; research insurance payments and corrections.
• Contact insurance companies, patients, and clinical departments to complete claims processing.
• Initiate and follow up on appeals, reopenings, and inquiries with insurers.
• Review reports and assist with ad hoc duties as assigned.

Skills

Medical claim denial experience

Insurance company communications

Attention to detail

Education

High school diploma or equivalent

Tools

Epic

CPT/ICD-10-CM/HCPCS knowledge

Job description

Christie Clinic's department of Business Services is seeking a full-time Patient Account Specialist from Monday-Friday 8:00am-4:30pm or 8:00am-5:00pm at the University clinic, with no night or weekend requirements. There is a possibility of working hybrid remote in the future following the successful completion of training and competencies as determined by the department.This role is responsible for researching medical claim denials, speaking with medical insurance companies and resolving medical claims and medical insurance issues. Performs analytical duties to ensure timely processing of medical claims to maximize reimbursement. Participates in cross-training and provides coverage for co-workers during the extended absence of a co-worker.JOB DUTIES: (This list may not include all of the duties assigned.)Verify insurance eligibility for patients by accessing on-line information available by through various carriers’ websites or via telephone for those that require that method.Process Charge Reviews via email and through the Guarantor Workqueues daily to verify information such as CPT & Diagnosis codes, dates of service and level of service, to request copies of documentation (email only) or research insurance issues.Post adjustments and remark codes in Epic and research insurance payments and process necessary corrections.Review assigned Workqueues daily, which includes contacting insurance companies for status of claims, contacting patients for insurance verification, and contacting clinical departments for additional information needed to complete claims processing.Send letters to patients for COB issues.Initiate and follow-up of appeals, reopenings and inquires with insurances companies.Respond to department inquiries regarding claims adjudication as needed.Respond to correspondence received from patients or insurance carriers.Review daily, weekly and monthly reports and complete as necessary.Perform other job duties as assigned.REQUIRED QUALIFICATIONS:High school diploma or equivalent.Medical claim denial experiencePREFERRED QUALIFICATIONS:Epic knowledgeCPT/ICD-10-CM/HCPCS knowledgeTYPICAL PHYSICAL DEMANDS:Work requires sitting for extended periods of time, walking, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, type at 60 WPM, operate a calculator, telephone, copier, fax machine and other such office equipment as necessary. Hearing must be within normal range or correctable for telephone contact and conversation. It is necessary to view and type on computer screens for long periods, meet deadlines and work in an environment which can be very stressful.TYPICAL WORKING CONDITIONS:Demands include sitting, standing, walking, bending, stooping, stretching and lifting up to 20 pounds. Hearing within, or correctable to, normal range, vision correctable to 20/20 and manual dexterity for the operation of office equipment is required.PAY AND BENEFITS:The estimated pay range for this position is exclusive of fringe benefits and potential bonuses. Final offers are based on various factors, including skill set, experience, qualifications, and other job-related criteria.We also offer a substantial benefits package, including:· Paid Time Off (Vacation, Sick, Personal, Holiday, Birthday)· Dependent Care Flexible Spending Account· 401k Plan· Medical Flexible Spending Account· Health Insurance· Group Term Life Insurance· Dental Insurance· Identity Theft Protection· Vision Insurance· Long Term Disability· Accidental Death & Dismemberment Insurance