Patient Account Specialist Senior

TEEMA Group; Lake Charles (LA); On-site; USD 52,000 - 76,000; Full time

Job summary

A healthcare solution provider is seeking a Senior Patient Account Specialist based in Lake Charles, LA, to join their medical collections unit. This role involves resolving denied claims, ensuring proper reimbursement, and advocating for patient satisfaction. The ideal candidate will possess expertise in medical collections and the insurance reimbursement cycle. Strong communication and analytical skills are crucial for success. Working hours are Monday to Friday with a focus on collaborative problem-solving.

Qualifications

• Proven track record of resolving complex healthcare accounts.
• Ability to adhere strictly to all client, state, and federal collection guidelines.
• Familiarity with large-scale hospital billing systems preferred.
• Must complete required medical screenings prior to start.

Responsibilities

• Collect outstanding balances from various payers for medical services.
• Identify and resolve denied or underpaid claims.
• Maintain expert knowledge of payer claims processing and payment methodologies.
• Utilize billing forms and navigate online payer portals.
• Communicate with stakeholders to resolve complex account issues.

Skills

Medical collections expertise

Insurance reimbursement knowledge

Interpersonal skills

Analytical skills

Conflict management

Education

High School Diploma or GED

Job description

Take a senior-level seat in a high-performing medical collections unit where your expertise directly impacts the financial health of a premier healthcare system. As a Senior Patient Account Specialist, you will navigate the complexities of insurance reimbursement, identifying and resolving denied or underpaid claims with precision and speed. This role is perfect for a detail-oriented professional who enjoys solving financial puzzles and advocating for proper reimbursement through professional communication with payers, patients, and vendors. You will be a key contributor to maintaining the structural integrity of the accounts receivable process while ensuring world-class patient and client satisfaction.

Key Duties

• Revenue Recovery: Collect outstanding balances from commercial, governmental, and third-party payers to ensure full and proper reimbursement for medical services.
• Claims Resolution: Proactively identify denied or underpaid claims, implementing timely solutions and appeals within specific payer guidelines.
• Knowledge Leadership: Maintain an expert-level understanding of payer claims processing, appeal procedures, provider contracts, and various payment methodologies.
• Technical Proficiency: Utilize a deep understanding of standard billing forms, filing requirements, and Explanation of Benefits (EOB) while navigating online payer portals.
• Trend Analysis: Identify and communicate recurring issues or industry trends that impact account resolution and overall reimbursement efficiency.
• Comprehensive Account Management: Manage both active Accounts Receivable (AR) and Bad Debt (BD) inventory, ensuring all documentation is accurate and compliant with state and federal guidelines.
• Stakeholder Collaboration: Facilitate professional communication with patients, clients, and reimbursement vendors to resolve complex account issues.

Required Qualifications

• Experience: Strong professional background as a medical collection specialist with a proven track record of resolving complex healthcare accounts.
• Skills: Expert knowledge of medical collection work processes and insurance reimbursement cycles.
• Compliance: Ability to adhere strictly to all client, state, and federal collection guidelines.
• Medical Requirements: Must complete all required medical screenings prior to start.

Desired Qualifications

• Communication: Exceptional interpersonal skills with the ability to manage conflict and provide a high level of patient and client satisfaction.
• Analytical Ability: Strong skills in identifying reimbursement trends and navigating various payer payment methodologies.
• System Knowledge: Familiarity with TLRA collection unit processes or similar large-scale hospital billing systems.

Location and Work Type

Setting: Hospital Corporate Office / TLRA Collection Unit

Work Type: On-site

Location: Lake Charles, LA

Schedule: Monday – Friday (8-hour shifts)

Education Note: High School Diploma/GED verification is no longer required for this specific role.

If you're interested, please reply to this advertisement or directly email your resume to me at [e-mail] or by calling/texting [phone].

I strive to reply within 48 hours. Looking forward to connecting with you soon. Thank you!