Account Resolution Specialist

EMSA- Emergency Medical Services Authority•Oklahoma City, OK

20h•Onsite

About The Position

The Account Resolution Specialist will conduct themselves in a professional manner that reflects the mission, vision, and values of EMSA. This role involves account resolution duties, including contacting payers or identified responsible parties for claim status and resolution. The specialist will monitor and document claim status, request necessary information, submit appeals, and accurately document accounts. They will post denials and take appropriate actions for account resolution, including submitting appeals, and apply adjustments as needed based on correspondence received. Additionally, the role requires reviewing and researching credit balances for account resolution, accurately processing correspondence related to patient accounts, and appropriately documenting patient accounts to reflect all updated and necessary information, including demographic or payer information. The specialist must maintain set quality and quantity productivity standards, understand revenue cycle key performance indicators (KPIs) and work to achieve team KPIs. Maintaining knowledge of current industry standards and organizational practices is crucial, as is working in a manner that supports a patient-centered, team-focused, and fiscally responsible organization. Communication with other team members and leaders on identified trends and process improvement opportunities is expected. The specialist must adhere to all organizational policies and work with the highest level of integrity, as well as adhere to and enforce all safety standards and organizational policies. Punctuality and regular, predictable, reliable, consistent attendance is essential. Other essential functions include professionalism, effective communication (verbally and in writing), maintaining confidentiality, exercising sound judgment, adaptability and flexibility, following safety and compliance protocols, accountability, compliance with the Code of Conduct, organizational policies, procedures, practices, and expectations, and performing core duties with or without reasonable accommodation. This position does not have supervisory or management responsibilities. Performs other job-related duties, functions, tasks, and responsibilities as assigned, which may vary based on evolving organizational needs and priorities. These responsibilities are not considered essential functions of the position and may be modified or reassigned to accommodate individuals with disabilities, in accordance with the Americans with Disabilities Act (ADA) as amended.

Requirements

Minimum GED or High School Diploma
Minimum 2 years’ experience in a hospital or physician’s office working patient accounts or insurance workflows.
Working knowledge of medical billing and medical terminology
Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
Excellent time management skills with attention to detail.
Ability to work independently and with a group and maintain good working relationships.
Must possess a valid driver’s license.
Must be able to successfully pass a background check and drug screen to the satisfaction of the organization.

Nice To Haves

Proficient with Microsoft Office Suite
Self-driven attitude with ability to meet organizational
Ability to work independently and with a group and maintain good working

Responsibilities

Conduct self in a professional manner that reflects the mission, vision, and values of EMSA.
Account resolution duties, to include contacting payers or identified responsible parties for claim status & resolution.
Monitoring and documentation of claim status, requesting necessary information, submitting appeals and accurate documentation of accounts.
Post denials and take appropriate actions to achieve account resolution, including submitting appeals.
Apply adjustments as needed based on correspondence received.
Review and research credit balances for account resolution.
Process correspondence related to patient accounts accurately.
Appropriately document patient accounts to reflect all updated and necessary information, including updated demographic or payer information.
Maintain set quality and quantity productivity standards.
Understands revenue cycle key performance indicators and works to achieve the KPIs of the team.
Maintain knowledge of current industry standards and organizational practices and work in a manner that supports a patient centered, team focused, and fiscally responsible organization.
Communicates with other team members and leaders on identified trends and process improvement opportunities.
Adhere to all organizational policies and work with the highest level of integrity.
Adhere to and enforce all safety standards and organizational policies.
Punctuality and regular, predictable, reliable, consistent attendance is essential.
Professionalism, the ability to communicate effectively (verbally and in writing), maintaining confidentiality, exercising sound judgment, being adaptable and flexible, following safety and compliance protocols, being accountable, complying with the Code of Conduct, organizational policies, procedures, practices, and expectations, and performing the core duties of the position either with or without a reasonable accommodation.
Performs other job-related duties, functions, tasks and responsibilities as assigned, which may vary based on evolving organizational needs and priorities.