Business Office Specialist I

Baptist Health Care • Pensacola, FL

7d

About The Position

The Business Office Specialist is responsible for performing duties in multiple CBO departments including accounts receivable follow up, payment posting, and charge posting as well as completing critical special projects and presentations related to accounts receivable reporting. This role involves investigating open items on accounts receivable that have aged beyond 30 days, contacting insurance carriers, patients, and healthcare providers to facilitate claims adjudication, and reconciling account balances by posting and correcting payments. The specialist will also investigate and resolve account denials, maintain the accounts receivable database, and track trending issues. Additionally, the role requires creating and presenting comprehensive reports for management and providers, researching and trending accounts receivable issues, and communicating with insurance representatives regarding reimbursement issues. The Business Office Specialist must prioritize work effectively and perform charge entry duties as needed.

Requirements

• High School Diploma or Equivalent Required
• 1-3 years relevant revenue cycle experience Required

Responsibilities

• Investigates open items on the accounts receivable as identified by Leadership, that have aged beyond 30 days from the date submitted to the appropriate insurance carrier to facilitate claims adjudication.
• Contacts insurance carriers, patients and health care providers by telephone and correspondence to assist with claims adjudication.
• Reconciles account balances by posting, correcting and reapplying patient and insurance payments for assigned financial class.
• Posts the corresponding contractual adjustments to patient accounts to reconcile account balances.
• Investigates and resolves account denials by submitting appeals and following up on appeals as needed to support the denial team.
• Maintains accounts receivable database, including updating patient account information.
• Responsible for tracking and establishing trending of new issues which continuously occur with changes in industry.
• Performs charge entry duties as necessary based on departmental needs.
• Creates and presents comprehensive reports for management and providers including presentations of critical information related to financial data and process improvement.
• Thoroughly research, track, and establish trending of issues related to accounts receivable.
• Participates in meetings and communicates with insurance representatives addressing ongoing reimbursement issues on accounts receivable identified as high risk.
• Communicate questions or concerns to the business services manager/director or physician’s office billing manager to ensure prompt resolution.
• Prioritize work assigned and complete in a timely manner.

What This Job Offers

• Career Level: Entry Level
• Education Level: High school or GED