Patient Account Specialist
About The Position
The Patient Account Specialist assists with inquiry management through phone, email, and online interactions with patients, healthcare teams, sales, and internal teams. The role investigates inquiries to determine the appropriate action to resolve, triage, or escalate them. This includes researching public and company-provided resources and systems, reviewing patient accounts, and completing necessary actions to achieve timely, effective first-time resolution. The specialist reviews and validates payer coverage requirements, maintains accurate patient information to support claims processing, identifies claim errors and payer trends, and builds positive partnerships with sales and internal and external cardiology healthcare teams. The role follows Baxter policies and guidelines and works toward departmental performance measures.
Requirements
- High school diploma or equivalent.
- At least 2 years of healthcare-related revenue cycle experience, with a focus on eligibility and benefit verification, authorizations, claims submission, and denial management.
- Knowledge of federal, state, and local regulations, guidelines, and standards, including HIPAA rules and regulations.
- CPT® and ICD-10 coding experience.
- Third-party payer experience.
- Experience reviewing medical records to identify and ensure medical necessity.
- Proficiency with Microsoft Office software.
- Strong critical-thinking and problem-solving skills.
- Exceptional written, verbal, and interpersonal communication skills.
- Ability to manage time and prioritize critical priorities.
- Must be authorized to work for any employer in the United States; visa sponsorship or transfer is not available.
Nice To Haves
- Cardiology-related experience.
Responsibilities
- Build rapport quickly over the phone while maintaining a positive, upbeat demeanor.
- Investigate and validate payer coverage policies and requirements as needed.
- Manage inquiries and provide timely, accurate resolutions to requests or complaints using multiple platforms and systems.
- Investigate issues, identify root causes, and provide accurate first-time resolution aligned with departmental KPIs.
- Review patient accounts promptly and accurately, assess customer needs, and determine the appropriate course of action under Baxter policies and guidelines.
- Ensure patient information on file is accurate to support timely and accurate claims processing.
- Identify and resolve claim errors that delay adjudication.
- Identify payer trends and establish payer-specific strategies to address reimbursement challenges.
- Establish and maintain positive partnerships with sales and internal and external cardiology healthcare teams.
Benefits
- Medical and dental coverage starting on day one for eligible roles.
- Basic life, accident, short-term and long-term disability, and business travel accident insurance.
- Employee Stock Purchase Plan with the ability to purchase company stock at a discount.
- 401(k) Retirement Savings Plan with employee contributions and company matching.
- Flexible Spending Accounts.
- Educational assistance programs.
- Paid holidays and paid time off ranging from 20 to 35 days based on length of service.
- Family and medical leaves of absence.
- Paid parental leave.
- Commuting benefits.
- Employee Discount Program.
- Employee Assistance Program.
- Childcare benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
