Patient Account Specialist-Full Time-Days

Cape-Fear-Valley-Medical-Center-; Fayetteville (NC); On-site; USD 36,000 - 52,000; Full time

Benefits offered by this job

Health benefits

Job summary

Cape Fear Valley Health System in Fayetteville, NC seeks a clerical professional to handle end-to-end patient account billing with third-party carriers, including claim submission, information gathering for adjudication, and responding to questions. The role supports accuracy and customer service across payer interactions.

The position requires 2 years of electronic billing or collections experience in a medical setting, strong English communication, and familiarity with CPT/ICD-10 codes.

Qualifications

• Education and Formal Training: High school diploma or equivalent required
• Work Experience: 2 years’ experience with electronic hospital billing or collections in a medical field required
• 1 year of experience with personal computer software and other office equipment required
• 1 year of medical terminology and familiarity with CPT-codes, ICD-10 codes and HCPCS codes preferred

Responsibilities

• Submits primary insurance claims to all carriers using the electronic claims terminal or send hard copy claims
• Uses the on-line work list and account referrals to review accounts that are pending payment from insurance companies for additional information
• Validates the accuracy of patient information so that future billing and follow-up activities are conducted effectively and to ensure a high degree of customer service.
• Applies adjustments and write-offs to accounts according to policy and procedure to assure accurate account balances and statements
• Maintains a suspense file of accounts that need additional documentation for eligibility determination prior to billing
• Receives incoming calls from patients and/or insurance companies concerning open accounts and answers questions and provides information in a courteous and cooperative manner to maintain good customer relations
• Other duties as assigned

Skills

Billing

Accounts receivable

Customer service

Electronic claims submission

Education

High school diploma or equivalent

Tools

UB-04 knowledge

Job description

Facility CFV Gastro VG West - Building Location Fayetteville, North Carolina Department CFV Gastroenterology Valleygate West Job Family Clerical Work Shift Days (United States of America)

Summary

Handles the complete processing of patient accounts with third party carriers from start to finish to include but not limited to: billing the claim either electronically or paper, supplying additional information necessary for claim adjudication, and answering patient and insurance company questions.

Major Job Functions

The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:

• Submits primary insurance claims to all carriers using the electronic claims terminal or send hard copy claims
• Uses the on-line work list and account referrals to review accounts that are pending payment from insurance companies for additional information
• Validates the accuracy of patient information so that future billing and follow-up activities are conducted effectively and to ensure a high degree of customer service.
• Applies adjustments and write-offs to accounts according to policy and procedure to assure accurate account balances and statements
• Maintains a suspense file of accounts that need additional documentation for eligibility determination prior to billing
• Receives incoming calls from patients and/or insurance companies concerning open accounts and answers questions and provides information in a courteous and cooperative manner to maintain good customer relations

Other duties as assigned

Minimum Qualifications

The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:

• Education and Formal Training: High school diploma or equivalent required
• Work Experience: 2 years’ experience with electronic hospital billing or collections in a medical field required
• 1 year of experience with personal computer software and other office equipment required
• 1 year of medical terminology and familiarity with CPT-codes, ICD-10 codes and HCPCS codes preferred

Knowledge, Skills, and Abilities Required

• Proficiency in reading, writing, and speaking the English language
• Knowledgeable in third party claim adjudication to include: Medicare, Medicaid, Tricare, commercial insurance, and managed care
• Must pass departmental training (calculating reimbursement, UB-04, Patient Account Terms and System Navigation) tests 75% or higher
• Excellent verbal and written communication skills
• Analytical ability and accurate mathematical calculation skills

Physical Requirements

• Near visual acuity required
• Motor coordination and finger dexterity required to complete repetitive functions with computer and other office equipment
• Ability to lift twenty-five pounds
• Ability to talk and to receive information by telephone is required

Required Licenses and Certifications

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity For exceptional healthcare come to Cape Fear Valley Health where caring employees are committed to integrity, patient-centeredness and excellence throughout the entire healthcare process. At Cape Fear Valley Health, our goal is to improve the quality of every life we touch. Our diverse team of doctors, nurses and staff work together to create a better experience for every patient, every time. Cape Fear Valley is a 950-bed, 8-hospital regional health system, the 8th largest in North Carolina, with more than 1 million inpatient and outpatients annually. A private not-for-profit organization with over 7,000 employees and 850 physicians. Our employees and physicians proudly serve a seven-county region of southeastern North Carolina, including Fayetteville, Fort Bragg, Hope Mills, Raeford, Lumberton, Elizabethtown, Clinton, Lillington, Dunn and beyond. Our medical facilities include Cape Fear Valley Medical Center, Highsmith-Rainey Specialty Hospital, Cape Fear Valley Rehabilitation Center, Behavioral Health Care, Bladen County Hospital, Hoke Hospital, Central Harnett Hospital, Betsy Johnson Hospital, as well as more than 60 medical offices and specialty care clinics spread throughout the Cape Fear region.