What are the responsibilities and job description for the Patient Account Specialist position at Pinehurst Resort?
Description
JOB SUMMARY
The Patient Account Specialist is responsible for managing and maintaining patient accounts as assigned by the Accounts Receivable Manager. This position works closely with internal and external customers to resolve unpaid claims, insurance discrepancies, and patient balances through timely and accurate follow-up. The goal of this role is to maximize reimbursement, ensure correct insurance payments, and uphold the principles of the “Flawless Reimbursement” system.
Responsibilities
QUALIFICATIONS
JOB SUMMARY
The Patient Account Specialist is responsible for managing and maintaining patient accounts as assigned by the Accounts Receivable Manager. This position works closely with internal and external customers to resolve unpaid claims, insurance discrepancies, and patient balances through timely and accurate follow-up. The goal of this role is to maximize reimbursement, ensure correct insurance payments, and uphold the principles of the “Flawless Reimbursement” system.
Responsibilities
- Process patient payments, refunds, and account adjustments.
- Identify and correct medical coding errors, data-entry mistakes, underpayments, and overpayments.
- Assist patients with billing inquiries, insurance questions, and account discrepancies.
- Communicate with patients via phone, email, or written correspondence regarding overdue balances & collections notifications.
- Ensure accurate insurance payments, follow up on denied or incorrect claims, and resolve payer inaccuracies.
- Perform billing and collection duties as needed to support the Accounts Receivable team.
- Utilize Blue E accounts and other payer portals for verification and follow-up.
- Counsel patients on insurance and billing matters, including pre-certification assistance.
- Exceptional verbal and written communication skills
- Excellent analytical and problem-solving abilities
- Strong time management and organizational skills
- Highly detail-oriented
- Outstanding customer service and patient support skills
QUALIFICATIONS
- 1–3 years of medical billing experience preferred
- Experience working with the public and maintaining composure in fast-paced environments
- Associate degree in a related field preferred
- Strong knowledge of insurance and managed care plans
- Understanding of billing and payment procedures for contractual and non-contractual payers
- Clear and concise communication skills with a professional demeanor
- Ability to read, comprehend, and follow written and verbal instructions
- Ability to learn quickly and adapt to a busy healthcare setting
- Sitting: Occasionally
- Standing: Occasionally
- Walking: Occasionally
- Carrying/Lifting: Rarely (up to 15 pounds)
- Stooping/Kneeling: Rarely
- Other: N/A