Patient Account Specialist-Full Time-Days

Cape Fear Valley Health

6d

About The Position

The Patient Account Specialist handles patient accounts with third-party carriers from start to finish. Duties include submitting claims electronically or on paper, supplying additional information needed for claim adjudication, and answering questions from patients and insurance companies. The role validates patient information, applies adjustments and write-offs according to policy, maintains accounts awaiting eligibility documentation, and supports accurate billing and follow-up while providing courteous customer service.

Requirements

• High school diploma or equivalent.
• Two years of experience with electronic hospital billing or collections in a medical field.
• One year of experience with personal computer software and other office equipment.
• Proficiency in reading, writing, and speaking English.
• Knowledge of third-party claim adjudication, including Medicare, Medicaid, Tricare, commercial insurance, and managed care.
• Pass departmental training tests in calculating reimbursement, UB-04, Patient Account Terms, and System Navigation with a score of 75% or higher.
• Excellent verbal and written communication skills.
• Analytical ability and accurate mathematical calculation skills.
• Near visual acuity.
• Motor coordination and finger dexterity to perform repetitive functions with a computer and other office equipment.
• Ability to lift 25 pounds.
• Ability to talk and receive information by telephone.

Nice To Haves

• One year of medical terminology experience and familiarity with CPT, ICD-10, and HCPCS codes.

Responsibilities

• Submit primary insurance claims to carriers using the electronic claims terminal or hard-copy forms.
• Review accounts pending insurance payment through online work lists and account referrals, and provide additional information as needed.
• Validate patient information to support effective billing and follow-up and maintain a high degree of customer service.
• Apply adjustments and write-offs according to policy and procedure to ensure accurate account balances and statements.
• Maintain a suspense file for accounts requiring additional documentation for eligibility determination before billing.
• Receive calls from patients and insurance companies about open accounts, answer questions, and provide information courteously and cooperatively.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED