Patient Services Specialist

Aprima; Town of Texas (WI); On-site; USD 40,000 - 50,000; Full time

Job summary

A health services organization located in Wisconsin seeks a dedicated individual to manage private insurance accounts and assist in Accounts Receivables operations. The role demands attention to detail, strong analytical and communication skills, with responsibilities including processing statements, answering calls, and maintaining HIPAA compliance. Ideal candidates will have a high school diploma and prior experience in physician billing. Join our team and contribute to health services with a commitment to organizational goals.

Qualifications

• Two years of experience in physician professional billing.
• Familiarity with Explanation of Benefit forms (EOB).
• Understanding of insurance carrier billing requirements.

Responsibilities

• Answer incoming calls.
• Run and process statements based on client preference.
• Maintain HIPAA compliance.

Skills

Detail-oriented

Organizational skills

Customer service

Analytical skills

Communication skills

Education

High school diploma/GED

Tools

Aprima PM practice management system

GE Centricity Business system

MS Excel

MS Word

Job description

Job Purpose: Maintenance of private Insurance accounts for patient billing and to assist the AR Manager/Supervisor in managing the Accounts Receivables for the physicians/clinics/clients that are assigned to them, by reducing the AR, resolving claim denials, and following payer specific processes surrounding the AR while managing their assigned task EPM inventory.

Responsibilities

• Answer incoming calls
• Run & Process Statements, as per client preference
• Work returned mail
• Convey balances, if applicable
• Provide feedback to team lead regarding denial trends
• Maintain strict confidentiality within medical practice and HIPAA compliance
• Maintain productivity standards and goals set by the department and/or manager.
• Maintain standard quality measures and goals.
• Attend Meetings as required and/or participate in various committees as required
• Other duties as assigned by Team Lead, Manager, Director, VP RCM.

Required Skills

• High school diploma/GED
• Preferably two years’ prior experience in physician professional billing (Managed Care, Commercial and or CMS Part B claims adjudication, including but not limited to:
  • Explanation of Benefit forms (EOB)
  • Credit balances (discounts and refunds)
  • Insurance carrier billing requirements
  • Collections
  • Familiarity of payer provider enrollment
  • CPT & ICD10 Coding

Core Competencies

Accountability and Self-Management

• Must be detail-oriented and organized
• A self‑starter capable of tracking to deadlines and meeting goals with little supervision required
• A high level of analytical and problem solving skills is expected

Team Player

• Ability to work autonomously and as a team player

Communication

• Excellent communication, customer service, and organizational skills
• Strong verbal and written communications

Innovation and Problem Solving

• Attention to detail and moderate analytical and problem solving skills is expected

Computer Skills

• Must possess general office skills and computer knowledge
• Strong working knowledge of the Aprima PM practice management system and/or GE Centricity Business system and coordinating modules, is preferred
• MS Excel Spreadsheet software, MS Word Processing software

Physical Demands

• May require sitting for long periods of time; also, stooping, bending, and reaching for files and supplies.
• Requires manual dexterity sufficient to operate a computer keyboard, answer a telephone, and run a copier and other office equipment as necessary.
• Employee must participate to help maintain the desirable work environment created by the management and company officials.

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.