Patient Account Specialist

ODYSSEY BEHAVIORAL GROUP•Anderson, IN

3d•Onsite

About The Position

The Patient Account Specialist is responsible for overall revenue cycle functions. The Patient Account Specialist helps improve cash flow and participates in increasing the overall health of the company’s receivables. Relationships and Contacts Within the organization: Maintains close and frequent contact with the finance and revenue cycle team members within Odyssey and other locations as assigned. Outside the organization: Maintains close and frequent contact with insurance providers and third-party vendors, as necessary.

Requirements

High school diploma or equivalent and at least two (2) years of healthcare insurance accounts receivable experience required.

Nice To Haves

Prior experience in Mental Health, Substance Abuse Disorder Treatment or behavioral healthcare field preferred.

Responsibilities

Performs timely follow up on aging AR.
Researches and resolves rejected, incorrectly paid, and denied 837 claims.
Keeps accurate and detailed updates in the billing software of all claims’ statuses.
Understands and consistently applies thorough understanding of all insurance plans.
Understands and interprets insurance Explanation of Benefits, knowing when and how to ensure that payment has been received.
Skillfully and professionally navigates phone calls with insurance companies and websites to effectively reprocess unpaid or incorrectly paid claims.
Understands authorizations and limits to coverage such as the number of authorizations/units.
Responds in a professional and timely manner to all billing-related inquiries from patients, staff and payers.
Completes complex billing functions, such as creating corrected claims, creating voided claims, secondary billing, and appeals.
Reviews patient bills for accuracy and completeness and obtain any missing information.
Consolidates and sends all requested medical documentation to insurance companies to ensure timely review and adjudication.
Provides excellent customer service with the ability to communicate to both insurance companies as well as families in the efforts of collecting outstanding balances.
Performs month end account review for remainder billing, Room & Board charges, and unapplied balances.
Documents billing and collection activities and communicates to supervisor as appropriate.
Prepares reports and reconciliations as needed.
Completes daily, weekly, and monthly assignments as assigned by Supervisor.
Maintains a strict level of confidentiality for all company, departmental, and healthcare provider information.
Functions within the guidelines of the facility’s Code of Ethics and in accordance with corporate compliance.
Updates job knowledge by participating in educational opportunities; reading professional publications related to the Odyssey Eating Disorder Network and population.
Provides a high level of customer service to both internal and external stakeholders.
Performs other related duties as assigned.