Patient Accounting Specialist - Support Personnel

Health First; Melbourne (FL); On-site; USD 42,000 - 54,000; Full time

Job summary

Health First in Melbourne, FL is seeking an experienced Medical Billing Specialist to support the Health First Medical Equipment business office. You will help ensure AR goals are met through timely billing and collections, handling claims processing, corrections, and payer negotiations.

The role requires thorough knowledge of ICD-9, CPT, HCPCS coding and strong computer skills, with experience in healthcare billing and collections.

Qualifications

• High School diploma required; college experience or Associates degree preferred.
• Three years’ experience in a health care facility.
• Thorough knowledge of computer applications used within the department.
• Advanced coding experience in ICD-9, CPT and HCPCS; coding certification preferred.
• Good understanding of medical terminology.
• Ability to articulate in a clear and concise manner.
• General understanding of accounting principles.
• Thorough knowledge of state and federal contracts and managed care.
• Thorough knowledge of government programs including Medicare, Medicaid and Tricare

Responsibilities

• Generates daily work flow for account representatives by obtaining all claims for processing through computer generated system downloads.
• Reviews, verifies, edits and troubleshoots complex claim information prior to submission/transmission of claim.
• Follow up and/or forward to appropriate individual or department.
• Update claim information; submit and transmit claim.
• Verify confirmation received on transmitted claims.
• Document actions and findings.
• Performs complex collection duties as follows: makes calls to responsible party to determine ability to pay account.
• Establishes payment arrangements or offers financial assistance such as charity, Medicaid, government assistance.
• Performs complex account resolution duties as follows: Detects and corrects errors; performs contractions adjustments and write-offs.
• Researches payer issues and account problems and takes corrective action.
• Has authority to negotiate payer issues according to patient business services policies.
• Ensures new staff is trained on departmental specific procedures and ensures compliance.
• Oversight and communication with staff performance.

Skills

Medical billing

AR collections

ICD-9/CPT/HCPCS coding

Computer software

Communication

Education

High School Diploma

Associates degree preferred

Tools

Billing software

Job description

POSITION SUMMARY

To be fully engaged in providing Quality/No Harm, Customer Experience, and Stewardship by providing superior quality, value and service by supporting the Health First Medical Equipment business office to ensure department accounts receivable goals are met through timely billing and collections.

Job Requirements

POSITION SUMMARY: To be fully engaged in providing Quality/No Harm, Customer Experience, and Stewardship by providing superior quality, value and service by supporting the Health First Medical Equipment business office to ensure department accounts receivable goals are met through timely billing and collections.

To be fully engaged in providing Quality/No Harm, Customer Experience, and Stewardship by providing superior quality, value and service by supporting the Health First Medical Equipment business office to ensure department accounts receivable goals are met through timely billing and collections.

Primary Accountabilities

Quality/No Harm

• Generates daily work flow for account representatives by obtaining all claims for processing through computer generated system downloads.
• Performs complex billing and account representative duties as follows:
• Reviews, verifies, edits and troubleshoots complex claim information prior to submission/transmission of claim.
• Follow up and/or forward to appropriate individual or department.
• Update claim information; submit and transmit claim.
• Verify confirmation received on transmitted claims.
• Document actions and findings.
• Performs complex collection duties as follows:
• Makes calls to responsible party to determine ability to pay account.
• Establishes payment arrangements or offers financial assistance such as charity, Medicaid, government assistance. Completes assistance application and reviews with established guidelines to approve or disapprove. Follow up and/or forward to appropriate individual or department. Document actions and findings.
• Performs complex account resolution duties as follows:
• Detects and corrects errors.
• Perform contractual adjustments and write-offs.
• Identifies payer specific edits and takes corrective action.
• Researches payer issues and account problems and takes corrective action.
• Has authority to negotiate payer issues according to patient business services policies.
• Ensures new staff is trained on departmental specific procedures which may include computer applications, and ensures associates follow policies and understand regulatory procedures.
• Oversee and participate in ensuring all staff is following departmental guidelines and procedures; follow up and communicate with department supervisor regarding staff performance.
• Performs office support and other duties as assigned

Customer Experience

• Timely delivery of patient and registration paperwork and plate to the patient care areas.
• Provide registration and other job requirements to meet the patient/family needs.
• Maintain successful relations with other Patient Business Services areas, Health First associates and physician office staff.
• Recognizes and identifies trends and makes recommendations for corrective action.

Stewardship

• Assist and participate in attaining Patient Business Services goals for Accounts Receivable, Cash and Bad Debt by collecting deductibles and co-pays from insured patients and deposits and/or payments for all self-pay patients.
• Assist in obtaining the PBS goal for Accounts Receivable days.

Work Experience

QUALIFICATIONS REQUIRED

• High School diploma required; college experience or Associates degree preferred.
• Three years’ experience in a health care facility.
• Thorough knowledge of computer applications used within the department.
• Advanced coding experience in ICD-9, CPT and HCPCS; coding certification preferred.
• Good understanding of medical terminology.
• Ability to articulate in a clear and concise manner.
• General understanding of accounting principles.
• Thorough knowledge of state and federal contracts and managed care.
• Thorough knowledge of government programs including Medicare, Medicaid and Tricare

Physical Demands

• Ability to sit at a computer terminal and telephone for extended periods of time.
• Ability to lift 40 pounds

MENTAL DEMANDS

• Ability to remain calm during stressful situations.
• Ability to manage multiple priorities.
• Ability to work independently

Benefits

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.

Schedule : Full-Time

Shift Times : 8:00am - 5:00pm

Paygrade : PG-26