Account Resolution Specialist

Minimum Qualifications

• • Minimum GED or High School Diploma
  • Minimum 2 years’ experience in a hospital or physician’s office working patient accounts or insurance workflows.
  • Working knowledge of medical billing and medical terminology
  • Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
  • Excellent time management skills with attention to detail.
  • Ability to work independently and with a group and maintain good working relationships.
  • Must possess a valid driver’s license.

Must be able to successfully pass a background check and drug screen to the satisfaction of the organization.

Essential Functions of the Position

• Conduct self in a professional manner that reflects the mission, vision, and values of EMSA.
• Account resolution duties, to include contacting payers or identified responsible parties for claim status & resolution.
• Monitoring and documentation of claim status, requesting necessary information, submitting appeals and accurate documentation of accounts.
• Post denials and take appropriate actions to achieve account resolution, including submitting appeals.
• Apply adjustments as needed based on correspondence received.
• Review and research credit balances for account resolution.
• Process correspondence related to patient accounts accurately.
• Appropriately document patient accounts to reflect all updated and necessary information, including updated demographic or payer information.
• Maintain set quality and quantity productivity standards.
• Understands revenue cycle key performance indicators and works to achieve the KPIs of the team.
• Maintain knowledge of current industry standards and organizational practices and work in a manner that supports a patient centered, team focused, and fiscally responsible organization.
• Communicates with other team members and leaders on identified trends and process improvement opportunities.
• Adhere to all organizational policies and work with the highest level of integrity.
• Adhere to and enforce all safety standards and organizational policies.

Punctuality and regular, predictable, reliable, consistent attendance is essential. Other essential functions include professionalism, the ability to communicate effectively (verbally and in writing), maintaining confidentiality, exercising sound judgment, being adaptable and flexible, following safety and compliance protocols, being accountable, complying with the Code of Conduct, organizational policies, procedures, practices, and expectations, and performing the core duties of the position either with or without a reasonable accommodation.

Other Functions of the Position

Performs other job-related duties, functions, tasks and responsibilities as assigned, which may vary based on evolving organizational needs and priorities. These responsibilities are not considered essential functions of the position and may be modified or reassigned to accommodate individuals with disabilities, in accordance with the Americans with Disabilities Act (ADA) as amended.

Knowledge, Skills, Abilities, and Other Characteristics

• Proficient with Microsoft Office Suite
• Self-driven attitude with ability to meet organizational
• Ability to work independently and with a group and maintain good working

Supervisory Responsibilities

• This position does not have supervisory or management responsibilities of other employees.

Physical Demands

• Hearing and talking to interpret job functions are frequently required and frequent visual ability to judge distance and space and clarity up to 20 ft.
• Occasionally may need to lift pull or pull objects up to 25 lbs. in all directions.

Work Environment

• Work is generally performed in an office setting sitting at a desk for prolonged periods with frequent repeating motions that may include wrists, hands, and fingers.
• Limited exposure to external environmental conditions, such as heat, cold, rain, snow and ice.