Patient Account Specialist - WI

Job Description

Overview

Patient Account Specialist - monitor assigned insurance carrier accounts for accuracy and to ensure prompt payments for services rendered. Follow up on patient accounts with overdue balances. Definitely needs to be fine with collection work.

M Health Fairview's Vibrant Health Clinic - River Falls, has an immediate opening for a Patient Account Specialist.

The primary purpose of this position is to monitor assigned insurance carrier accounts for accuracy and to ensure prompt payments for services rendered. This position involves follow-up communication on patient accounts with overdue balances via telephone and /or correspondence.

This is a full time, 1.0 FTE (80 hours per two week pay period), benefits-eligible position. The schedule for this position is Monday-Friday 8am-5pm.

Responsibilities/Job Description

• Maintains all required and appropriate records and tracking systems for all assigned insurance carrier accounts.
• Monitors aging and account reports to assure prompt payments on accounts are being paid from insurance carriers and patients under the terms of the fee schedule or contract.
• Contacts customers with delinquent accounts via telephone and/or correspondence as required reviewing status of their account or obtaining missing account information
• Reviews and files electronic or paper claims with appropriate insurance carriers in a manner which ensures accurate information and coding on claims and that claims are filed in a timely manner.
• Work Revenue Manager Que on assigned insurance claims.
• Review EOBs and followings up on secondary claims.
• Posts zero remits and electronic remits as assigned.
• Processes adjustments to patient’s accounts, such as co-payments, deductibles, payments, denials, discounts, in a manner, which ensures that accurate and up-to-date information is in place.
• Refiles claims to insurance carriers for unpaid charges and provides additional information when required.
• Refunds insurance and/or patient credit balances.
• Pre-registers new patient insurance information and verifies eligibility and benefits.
• Updates inaccurate information on accounts.
• Assists patients with questions concerning processing of claims, collections, credit information and payment plans.
• Assists insurance carriers with questions concerning processing of claims and/or account information.
• Processes mail returns through Apex.
• Prepares delinquent accounts with required information and routes to Business Office Manager/Administrator for review and approval prior to sending account to third party collection agency.
• Updates third party collection agency with new information on delinquent accounts.
• Maintains confidentiality of all information acquired through employment with the Clinic, including patient's medical records and Clinic business information.
• Establishes and maintains positive working relations and open communication with customers, Health Care Providers, internal personnel, as well as personnel from other facilities.
• Establishes and maintains positive working relationships and open communication with customers and all members of the Health Care Home team.
• Assists in Quality related activities regarding operational efficiency and in accordance with the clinics Quality Program.

Qualifications

Required:

• High School Diploma/GED is required
• Ability to work independently with minimal instruction, in a team environment
• Computer, knowledge of medical terminology, basic knowledge of accounting/bookkeeping practices, collections, and health care insurance
• Good interpersonal and communication skills

Preferred:

• Post-secondary education/training is preferred
• Two years' prior experience in health care billing or collections in a clinic setting