Patient Account Specialist

Scripps Health•San Diego, CA

12h•Onsite

About The Position

The Patient Account Specialist is responsible for a variety of billing and follow-up tasks relating to claims processing; contacts responsible parties to resolve past-due accounts; investigates account status and initiates collection. Submits claims and follows up with payors to account resolution. Identifies problem accounts with payors; investigates and corrects errors, follows-up on missing account information, and appealing unpaid and denied claims. Working directly with the insurance company, healthcare provider, liable third parties and patient to get a claim processed and paid. Supports continuous improvement of organization processes and personal knowledge and skills. Maintains and protects confidential information. Provides excellent customer service through cooperative working relationships. Meets productivity and quality standards.

Requirements

Strong working knowledge of managed care plans, insurance carriers, government Payers and payer requirements
Knowledge of Medical Terminology and Medicare Compliance
Familiarity with HIPAA privacy requirements for patient information
Basic understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPC Codes
Ability to multitask and stay organized
Good verbal and written communication skills
Detail oriented and ability to prioritize work
Requires a moderate level of interpersonal, problem solving, and analytic skills
Knowledgeable on insurance and reimbursement process
Ability to establish/maintain cooperative working relationships with staff, Medical Staff and providers

Nice To Haves

Two years of patient accounts experience in a healthcare setting

Responsibilities

Billing and follow-up tasks relating to claims processing
Contact responsible parties to resolve past-due accounts
Investigate account status and initiate collection
Submit claims and follow up with payors to account resolution
Identify problem accounts with payors
Investigate and correct errors
Follow up on missing account information
Appeal unpaid and denied claims
Work directly with the insurance company, healthcare provider, liable third parties and patient to get a claim processed and paid
Support continuous improvement of organization processes and personal knowledge and skills
Maintain and protect confidential information
Provide excellent customer service through cooperative working relationships
Meet productivity and quality standards