Patient Accounts Spc,

Conifer Health Solutions•Marietta, GA

10h

About The Position

The Patient Accounts Specialist role encompasses a variety of technical and specialized functions within the patient financial services department. Depending on the specific assignment, individuals may be responsible for coding, posting, claim resolution, or benefits coordination. This role may also involve assisting with new hire training. Maintaining patient confidentiality and adhering to all company policies and procedures, including work schedule and attendance, is paramount. The department operates with variable work schedules between 7:00 am and 6:30 pm, Monday through Friday, with potential adjustments based on departmental needs. Duties are subject to change at management's discretion.

Requirements

High school diploma or GED.
Coding: CCS, CCS-P or CPC certified or certification in process.
Coding: 4+ years Ophthalmology experience.
Posting: College Degree or High School Diploma.
Posting: 4+ years Ophthalmology experience.
Posting: Experience with managed care contracts.
Claims Resolution: CPC certified or certification in process.
Claims Resolution: Medical Practice experience 2+ years.
Benefits Coordination: Minimum of one year experience in a hospital admitting/registration practices insurance and managed care areas.
Maintain patient confidentiality.
Adhere to all policies and procedures.
Adhere to work schedule and time and attendance policies.

Nice To Haves

Healthcare Experience preferred.
Posting: Payment posting experience is preferred.

Responsibilities

Reviews, analyzes, and codes diagnostic and procedural information for reimbursement.
Performs ICD-10-CM, CPT, and HCPCS coding, ensuring compliance with coding guidelines, reimbursement policies, and regulations.
Assigns and sequences codes to diagnoses and procedures, ensuring accuracy and completeness.
Edits claims (claim scrubbing), performs charge entry, and follows up on electronic claim submissions and rejections.
Coordinates and reports on co-managed surgeries.
Independently evaluates explanations of payments and correspondence, accurately posting or recording collection receipts.
Processes and files information regarding collection receipts, demonstrating quick evaluation and attention to detail.
Researches and corrects claim denials, documents all correspondence, and receives patient payments.
Responds to inquiries from patients, insurance carriers, and clients within two business days.
Follows up and resolves all unpaid insurance claims for assigned payors.
Utilizes the Clearwave system to ensure accurate insurance information for claim filing.
Verifies appropriate insurance benefit coverage, authorization, and notification for all services prior to scheduling.
Completes work lists in a timely manner.