Patient Accounts Specialist

Wyckoff Heights Medical Center; New York (NY); On-site; USD 55,000 - 75,000; Full time

Job summary

Wyckoff Heights Medical Center in Brooklyn, NY, is seeking a Finance/Payroll Billing professional. The role focuses on Medicare/Medicaid and commercial billing, claim adjudication, and payer communication.

You will manage AR, post remittances, assist patients, and respond to audits while working with multiple systems. Ideal candidates have 3+ years in hospital billing, familiarity with government and commercial guidelines, and strong attention to compliance and productivity in a fast-paced

Qualifications

• This role requires a high school diploma or equivalent and at least 3 years of related experience.
• 3+ years of medical hospital billing experience preferred.
• Familiar with government and commercial hospital billing guidelines and regulations.

Responsibilities

• Understands Medicare, Medicaid, Managed Care, and Commercial insurance fundamentals.
• Resolves billing edits timely and reviews billing work queues to ensure claims are released and accepted by payers.
• Performs diligent account follow-up, resolving A/R balances timely and effectively.
• Posts hospital remittances electronically and/or manually in the Allscripts system.
• Assists patients with hospital bills and inquiries.
• Responds to payer/regulatory audit requests timely (e.g., Cotiviti, OMIG, IPRO).
• Familiar with Allscripts, Change Healthcare scrubber/clearinghouse, payer portals, and related systems.
• Escalates payer, patient, reimbursement, compliance, regulatory, workflow, and technology issues to Management.
• Collaborates with external departments and processes requests (e.g., UB-04).
• Meets departmental quality and productivity standards.

Skills

Medicare/Medicaid knowledge

Billing compliance

Payer communications

Accounts Receivable

Allscripts

Education

High School Diploma or equivalent

Tools

Payer portals

Job description

Location

Wyckoff Heights Medical Center | Finance / Payroll / WIC
316A Himrod St
Brooklyn, NY 11237, USA

Description

• Understands Medicare, Medicaid, Managed Care, and Commercial insurance fundamentals.
• Understands federal and state regulatory requirements and compliance standards.
• Working knowledge of coding / reimbursement methodologies, including MS-DRG / APC, APR-DRG / APG, and fee schedules.
• Resolves billing edits timely and works / reviews billing work queues and/or reports to ensure claims are released and accepted by payers within the contracted timeframe.
• Performs diligent account follow‑up, resolving A/R balances timely and effectively. Follow‑up functions include but are not limited to: payer portal claim status checks, calling payer, submitting requested documentation (e.g., Medical Records) appealing denied claims, making outbound patient calls, updating insurance and generating claim rebills, adjusting receivable balances to the appropriate adjustment code & within departmental staff threshold, etc.
• Performs accurate payment reviews.
• Works credit balances and follows departmental payer and patient refund procedures.
• Posts hospital remittances electronically and/or manually in the Allscripts system.
• Assists patients with hospital bills, inquiries, etc.
• Responds to payer / regulatory audit requests timely (e.g., Cotiviti, OMIG, IPRO).
• Manages / works correspondence in a timely fashion. Ensures correspondence is scanned into the Allscripts system as appropriate.
• Documents actions in Allscripts and other appropriate systems. Adheres to departmental documentation standards.
• Familiar with Allscripts electronic billing system, Change Healthcare scrubber / clearinghouse, payer portals, Revenue Cycle Workflow application (TRAC), and audit tracking system.
• Ability to work in multiple system applications and highly comfortable with using a computer.
• Proactively escalates payer, patient, reimbursement, compliance, regulatory, workflow, and technology issues to Management.
• Collaborates and effectively communicates with external departments. Processes external department requests timely (e.g., UB-04).
• Engages in departmental meetings and training opportunities.
• Meets departmental quality and productivity standards.
• Works special projects as assigned.
• Completes other duties as assigned.

Position Requirements

• This position requires a minimum formal education of High School Diploma or equivalent and a minimum of 3 years job‑related experience.
• Desired (not required) criteria include: 3+ years of medical hospital billing experience.
• Experienced in Government and Commercial hospital billing guidelines and regulations. Must be able to research multiple issues and effectively communicate outcome while meeting internal quality and productivity guidelines.

Union:1199

Days: Mon - Fri

Shift: 9am - 5pm

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.