Patient Accounts Specialist I

  • Job Summary
    • Interprets and evaluates appeals to include follow-up with payers to assure timely turn around for claimsresolution and reimbursement. Must be able interpret explanation of benefits and have a clear understandingof payer methodology. Works in a team environment.
  • Minimum Qualifications
    • Education/Training
      • High school graduation or equivalent.
    • Experience
      • 1 year experience in patient accounting, accounts receivable, or related healthcare field, or anequivalent combination of experience and college education in Accounting, Finance or HealthcareAdministration.
    • License/Certification/Registration
      • No special certification, registration or license required.
    • Knowledge, Skills & Abilities
      • Detailed working knowledge and demonstrated proficiency in at least one specific payers applicationbilling and/or collection process. Requires basic working knowledge of UB04 and Explanation of Benefits(EOB). Requires some knowledge of medical terminology and CPT/IDC-9 coding. Excellent communication,analytical, interpersonal, and organizational skills. Proficient uses of hospital registration and/or billingsystems and personal computers as well as Microsoft Excel and Word applications. Ability to type 35 WPM.
  • Primary Duties and Responsibilities
    • Attends training sessions and workshops offered, to include but not limited to, CPAT Training, bulletin review, etc. Attends and successfully completes required Continuing Education Units (CEU) for the PFS Training Program. Completes annual mandatory training (SITEL) within defined time frame.
    • Keeps abreast of regulatory and specific changes as it relates to billing requirements and payer specific follow up.
    • Maintains daily performance benchmarks as it relates to appeals resolution and reimbursement. Completes standard accounts per day for both in-patient and outpatient. Files appeals according to state guidelines.
    • Maintains departmental QA standard within established error rate.
    • Meets team specific benchmark as it applies to completed Tracking Forms on a daily basis and follow-up on appeal status, >$10K, >$20K, AR15, AR30, and AR45.
    • Participates in PFS workgroups, staff meetings and work events.
    • Performs other duties as assigned.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.

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