Patient Accounts Specialist

Avera•Sioux Falls, SD

2d•Onsite

About The Position

Accountable for having a high level of knowledge of the Avera Medical Group patient accounts responsibilities for the Avera Medical Group Clinics. They are responsible for complete follow-up of patient accounts, working closely with insurance companies and internal team members to resolve account issues.

Requirements

The individual must be able to work the hours specified.
To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.
Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
Promote Avera’s values of compassion, hospitality, and stewardship.
Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
Maintain confidentiality.
Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Nice To Haves

Associate's or technical degree.
1-3 years of related experience.

Responsibilities

Responsible for follow-up on accounts receivable by contacting insurance companies.
Closely follows the appropriate procedures and practices.
Responsible for account review and follow up of unpaid, overpaid/over adjusted and denied claims.
Reviews, analyzes, and appeals denials received relative to claims processing issues with insurance payers.
Communicates with internal and external customers involved in the claims resolution process to ensure timely claims processing.
Identifies the need to rebill claims through account review and completes claim refiling as well as submits secondary claims not auto- generated through the system.
Assist with patient responsibility follow-up as needed.
Responsible for being available to answer direct patient inquiries.
Support any on site facility needs as determined by leadership.