Patient Accounts Specialist I (Physician Billing)
MedStar Physicians' Billing Services (MPBS) is currently seeking experienced Patient Accounts Specialists Level I to join our amazing team. On-site training in Middle River, Maryland required. After training associates get to enjoy a hybrid work schedule with four days working remotely and one day in the office located in Middle River. Job SummaryPerforms accounts receivable follow-up/collection procedures to obtain timely reimbursement from third party carriers and other payment sources on insurance invoice balance of = $3000.00 for a portion of approximately one billion dollars of annual accounts receivable. Performs collection activity for assigned divisions, third party carriers and individual providers. Maintains contacts with third party carriers and communicate billing/reimbursement changes to management in timely manner. Assists in evaluation of accounts receivable and participate in development of collection strategies to decrease outstanding balances.Minimum QualificationsEducation/TrainingHigh School Diploma or equivalent; some college preferred. Consideration will be given to an appropriate combination of education/training and experience.Experience2 years collection experience in medical billing operations. Experience and proficiency using an automated billing system, GE IDX and ETM experience preferred.License/Certification/RegistrationNo special certification, registration or license required.Knowledge, Skills & AbilitiesKnowledge of ICD9/10 and CPT4 coding as it relates to third party carrier reimbursement. Knowledge of federal, state and local legal and regulatory provisions that relate to collection activities. Knowledge of third party carrier operating procedures and practices particularly as they relate to levels and methods of reimbursement. Proven skill in defining problems, collecting data, interpreting billing information. Ability to examine documents for accuracy and completeness, to prepare records in accordance with detailed instructions. Excellent organizational and analytical skills that ensure successful and accurate completion of daily quota driven processing. Proficiency in use of computer and calculator. Effective verbal and written communication skills.Primary Duties and ResponsibilitiesAssists in maintaining integrity of the accounts receivable system database by reviewing data input for completeness and accuracy - including updating account information and transferring charges to correct financial class.Collects and determines follow up needed on outstanding accounts receivable with an invoice balance less than or equal to $3,000.Contacts insurance carriers directly to confirm receipt of claim(s).Exemplifies Guest and Staff Relations standards in all activities in areas of service, resource utilization, high quality outcomes and effective communication.Follows appeal procedures for denied claims and reimbursement below contractual fee schedule.Identifies patient/third party carrier complaints, resolves and communicates these complaints to management.In accordance with operational policies and procedures, makes adjustment to patient accounts as necessary to facilitate timely reimbursement.Maintains collection follow-up notes utilizing GE IDXETM software.Meets the Performance ETM Production quota set at 100% of the established quota.Monitors assigned accounts receivable categories until payments are received and posted.Obtains necessary billing/appeal information from provider/division/electronic record/billing contact/patient to facilitate timely claim/appeal adjudication.Participates in educational/professional development activities.Provides supporting documentation at time of claim appeal to facilitate timely reimbursement.Reports status of delinquent accounts.Resolves billing issues if necessary.Sorts, distributes, and responds to incoming mail from insurance carriers.Uses support capabilities of accounts receivable billing system to obtain appropriate information and work product.Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.Performs other duties as assigned.