Patient Accounts Specialist I - Physicians' Billing

MedStar Health; Washington (District of Columbia); On-site; USD 26,000 - 45,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Tuition assistance

Retirement plans

Job summary

MedStar Health seeks an experienced Patient Accounts Specialist to support physicians' billing services within the revenue cycle. The role requires at least two years of physician patient accounts and collections experience, with a strong focus on denial resolution and appeals processing to ensure timely reimbursement.

Responsibilities include AR follow-up, data integrity, and collaboration with management to develop collection strategies.

Qualifications

• 2 years collection experience in medical billing operations.
• Experience with GE IDX and ETM preferred.
• Knowledge of ICD9/10 and CPT4 coding for third party reimbursement.
• Familiarity with federal, state and local regulations related to collections.
• Strong analytical and organizational abilities.

Responsibilities

• Assists in maintaining integrity of the accounts receivable system database by reviewing data input for completeness and accuracy.
• Collects and determines follow-up needed on outstanding accounts receivable with an invoice balance <= $3000.
• Follows appeal procedures for denied claims and reimbursement below contractual fee schedule.
• Identifies patient/third party carrier complaints, resolves and communicates these complaints to management.
• Makes adjustments to patient accounts as necessary to facilitate timely reimbursement.
• Meets the Performance ETM Production quota at 100% of the established quota.
• Monitors assigned accounts receivable categories until payments are received and posted.
• Obtains necessary billing/appeal information to facilitate timely claim/appeal adjudication.

Skills

Organizational skills

Analytical skills

Problem solving

Data interpretation

Education

High School Diploma or GED

Some college preferred

Tools

GE IDX

ETM

Job description

About the Job

MedStar Health is seeking an experienced Patient Accounts Specialist to join our revenue cycle team supporting our physicians' billing services.

The ideal candidate will have at least two years of experience in physician patient accounts and collections within medical billing operations. They must also have a strong understanding of denial resolution and appeals processing to ensure timely and accurate reimbursement.

In this role you will perform accounts receivable follow-up/collection procedures to obtain timely reimbursement from third party carriers and other payment sources on insurance invoice balances. Performs collection activity for assigned divisions, third party carriers and individual providers. Maintains contacts with third party carriers and communicates billing/reimbursement changes to management in timely manner. Assists in evaluation of accounts receivable and participate in development of collection strategies to decrease outstanding balances.

MedStar Health is a great place to work and grow your career. We provide a supportive and inclusive work environment, comprehensive health and wellness benefits, generous paid time off, tuition assistance, retirement plans, and many other benefits focused on your wellbeing.

Primary Duties and Responsibilities

• Assists in maintaining integrity of the accounts receivable system database by reviewing data input for completeness and accuracy - including updating account information and transferring charges to correct financial class.
• Collects and determines follow-up needed on outstanding accounts receivable with an invoice balance less than or equal to $3000.
• Follows appeal procedures for denied claims and reimbursement below contractual fee schedule.
• Identifies patient/third party carrier complaints, resolves and communicates these complaints to management.
• In accordance with operational policies and procedures makes adjustment to patient accounts as necessary to facilitate timely reimbursement.
• Meets the Performance ETM Production quota set at 100% of the established quota.
• Monitors assigned accounts receivable categories until payments are received and posted.
• Obtains necessary billing/appeal information from provider/division/electronic record/billing contact/patient to facilitate timely claim/appeal adjudication. Provides supporting documentation at time of claim appeal to facilitate timely reimbursement.

Minimal Qualifications

Education

• High School Diploma or GED required; some college preferred
• Consideration will be given to an appropriate combination of education/training and experience.

Experience

• 2 years collection experience in medical billing operations required
• Experience and proficiency using an automated billing system GE IDX and ETM experience preferred

Knowledge Skills and Abilities

• Knowledge of ICD9/10 and CPT4 coding as it relates to third party carrier reimbursement.
• Knowledge of federal state and local legal and regulatory provisions that relate to collection activities.
• Knowledge of third-party carrier operating procedures and practices -- particularly as they relate to levels and methods of reimbursement.
• Proven skill in defining problems, collecting data, and interpreting billing information.
• Excellent organizational and analytical skills that ensure successful and accurate completion of daily quota driven processing.

This position has a hiring range of USD $18.70 - USD $32.72 /Hr.