Patient Accounts Specialist- Insurance

Emerus•Remote,

10d

About The Position

The Patient Accounts Specialist assists in managing the company’s outstanding receivables through routine communication with payers, including commercial insurers, Medicare, and private-pay patients. The role helps ensure that expected reimbursement for patient care is processed promptly and paid accurately. The position also supports accurate accounts-receivable reporting and works toward goals related to accuracy and productivity.

Requirements

High school diploma or GED.
At least 2 years of experience in a provider setting, inpatient or outpatient.
Knowledge of payors and insurance, self-pay after insurance, reimbursements, collections, appeals, claims follow-up, and third-party billing.
Experience with medical records or patient accounting systems.
Knowledge and understanding of state and federal payment laws.
Knowledge and understanding of healthcare explanations of benefits (EOBs).
Experience with a 10-key adding machine.
Fluency in English and written and oral communication skills.

Responsibilities

Follow up on submitted claims and take appropriate action to ensure timely receipt and appropriate reimbursement.
Communicate with payers about delinquent or denied claims, address issues, and remove barriers to payment.
Manage claim details and verify accurate reimbursement; initiate account adjustments or appeals for payment disputes.
File appeals for denied claims and follow up through appeal resolution.
Manage and maintain outstanding patient balances to ensure accurate accounts-receivable reporting.
Use online and telephone resources to verify benefits and ensure claims are processed according to appropriate benefit levels.
Submit refund requests as necessary.
Work on special projects as assigned by the Supervisor, Director, or CFO.
Meet position goals and objectives related to accuracy and productivity, such as days in accounts receivable and cash collections.
Attend required staff meetings and other company-sponsored or mandated meetings.
Perform additional duties as assigned.
Work overtime when needed.