Job description

The Patient-Insurance Account Specialist manages accounts receivable to ensure timely and accurate billing and reimbursement of patient accounts not to exceed sixty days.

ESSENTIAL FUNCTIONS:

· Reviews, monitors and manages the Patient A/R (patient balances) not to exceed 60 days on all patient statuses.

· Processes insurance denials and appeals for all outstanding insurance claims in a timely manner.

· Accurately posts personal payments and adjustments as assigned.

· Daily balances all transactions posted.

· Answer all patient billing and insurance concerns using good knowledge and checking resources to accurately respond.

· Answers other calls to the billing department and provides information as requested.

· Works with patients in securing prepayment sources or financial agreements prior to providing services.

· Verifies insurance benefits in responding to Front Office inquiries as needed.

· Files "Bankruptcy" claims.

· Files "Probate" claims on deceased patient accounts.

· Generates and prints "Patient Bills to Be Printed" list; reviews and verifies correct patient balances.

· Sorts, opens, and distributes incoming mail to appropriate staff.

· Resolves coding and error resolution by following payer guidelines.

· Outsources collection accounts to a professional collection agency after exhausting all collection efforts monitor their performance; reports results to Billing Supervisor monthly.

· Cross trains and is back-up to the Billing Specialist during absenteeism.

· Maintains strictest confidentiality; follows HIPAA procedures.

· Performs related work as required.

KNOWLEDGE, SKILL AND EXPERIENCE:

· High School Diploma or GED required

· Minimum one year medical billing office or patient account processes

· Knowledge of insurance reimbursement procedures and practices preferred

· Knowledge of medical terminology preferred

· Strong organizational skills

· Ability to prioritize work during heavy workload situations

· Proficient in Windows environment and Microsoft Office

· Have excellent written and oral communication skills; excellent telephone etiquette skills

· Experience with medical records; Previous EHR experience, Epic a plus

· Ability to work independently and work effectively as a team contributor on day to day assignments.

· Ability to maintain quality control standards.

· Ability to interpret, adapt and apply guidelines and procedures.

COMPETENCIES:

To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of the position satisfactorily:

Communication

Able to read, analyze and interpret general business periodicals, correspondence, etc. Able to write clear communications. Able to effectively present information and respond to questions to all levels; Expresses thoughts clearly; Listens well.

Initiative

Actively seeks opportunities to make contributions vs. passively accepting situations. Goes above expectations to achieve goals.

Decision Making:

Makes decisions with sound judgment and a realistic understanding of issues.

Flexibility

Recognizes/responds to unanticipated events and requirements.

Dependability/Adaptability

Recognizes/responds to unanticipated events and requirements. Customer-focused, with demonstrated experience and ability to be flexible with changing priorities, demands and requests.

Interpersonal Relationships

Promotes teamwork, and leads by example, while successfully collaborating across functions and departments. Understands, responds to others’ needs and priorities.

Diversity Oriented

Recognizes/values the benefits of the diversity of people, ideas and cultures.

Personal Responsibility

Trustworthy with unyielding integrity.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job, these include: utilize manual dexterity and eye-hand coordination to complete computer, handwriting, and telecommunication tasks; have normal/corrected vision and hearing to within normal range, and able to work under stressful conditions and/or work irregular hours. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee frequently is required to reach with hands and arms. The employee is occasionally required to stand; walk; and stoop, kneel, crouch, or crawl.

WORK ENVIRONMENT:

The job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers and fax machines. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

Job Type: Full-time

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Experience level:

• 2 years

Schedule:

• Monday to Friday

Experience:

• Filing Claims/Denials/Appeals: 1 year (Required)

Work Location: In person

Job Type: Full-time

Pay: $18.00 - $21.00 per hour

Ability to Commute:

• Fort Myers, FL 33907 (Required)

Ability to Relocate:

• Fort Myers, FL 33907: Relocate before starting work (Required)

Work Location: In person