Patient Accounts Specialist - PHO Team

MedStar • Columbia, MD

120d • $18 - $31

About The Position

MedStar Health is currently seeking an experienced Patient Accounts Specialist to join our Patient Accounting PHO team. We are specifically looking for candidates that have experience with facility and/or physician billing, claims follow-up, researching claim denials and preparing/writing appeals to get claims paid. The Patient Accounting PHO (Physician Hospital Organization) Department works all commercial transplant and cardiac services for two MedStar Health hospitals located in Washington, DC. The team does the billing as well as 'follow up' on claims where no payment has been received or when only partial payment is received. The team issues written appeals for denials and completes reconciliation of payments. The DC facilities work off a contract-based reimbursement system, team members are familiar with all the contracts for each payer for each facility.

Requirements

• High School Diploma or GED required.
• 1-2 years' experience in patient accounting, accounts receivable or related healthcare field required or an equivalent combination of experience and college education in accounting, finance or healthcare administration required.
• Detailed working knowledge and demonstrated proficiency in at least one specific payers application billing and/or collection process.
• Basic working knowledge of UB04 and Explanation of Benefits (EOB).
• Some knowledge of medical terminology and CPT/ICD-10 coding.
• Excellent communication, analytical, interpersonal, and organizational skills.
• Proficient uses of hospital registration and/or billing systems and personal computers as well as Microsoft Excel and Word applications.
• Ability to type 35 WPM.

Responsibilities

• Interprets and evaluates appeals to include follow-up with payers to assure timely turn around for claims resolution and reimbursement.
• Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards.
• Complies with governmental and accreditation regulations.
• Attends training sessions and workshops offered, to include but not limited to, CPAT Training, bulletin review, etc.
• Attends and successfully completes required Continuing Education Units (CEU) for the PFS Training Program.
• Completes annual mandatory training (SITEL) within defined time frame.
• Keeps abreast of regulatory and specific changes as it relates to billing requirements and payer specific follow up.
• Maintains daily performance benchmarks as it applies to interpreting and evaluating appeals to include follow up with payers.
• Completes coding report updates within the standard set in a timely manner to begin the daily workflow process.
• Responsible for reconciliation of reports to SMS and information that was posted.
• Maintains departmental QA standard within established error rate.
• Meets team specific benchmark as it applies to completed Tracking Forms forwarded to the Operational Desk after completion on a daily basis, >$10K, >$20K, AR15, AR30, and AR45.
• Participates in PFS workgroups, staff meetings and work events.
• Participates in multi-disciplinary quality and service improvement teams.

Benefits

• This position has a hiring range of $18.33 - $31.61.

What This Job Offers

• Career Level: Entry Level
• Industry: Administrative and Support Services
• Education Level: High school or GED