Patient Account Specialist- Clinical Denials

Facility:

Work From Home - Ohio

Department:

Clinical Denials

Schedule:

Full time

Hours:

40

Job Details:

Responsible for all billing and collection activity for assigned patient accounts from date of initial claim submission to accurate final account payment and ultimate zero balance. This may include research and contact with patient, guarantor, insurance companies, Medicaid/Medicare and/or other third party payers. Responsible for billing of account, review of payment accuracy, account research and follow up. Efforts may include financial, clinical or demographic account correction, coordination with service providers and payers, research for denied payments, rebilling of account, coordination of benefits with guarantors and timely follow up of payment. Also may include processing of credit balances and rebilling of patient accounts as needed in order to obtain hospital payment for services. Provides oversight of assigned aging reports including credit balances and utilizes automated Health Information System(s) for account review, claim status and account documentation. Must stay current on all payer/Medicare/Medicaid billing requirements which may include attending seminars or other professional development activities. Maintain high level of accuracy and assures compliant billing of claims. Communicates payer trends impacting revenue to supervisor.

Department Specific Job Details:

Shift

• 8am-4:30pm (flexible)

Education

• High school diploma or GED

Experience

• Customer service in a call center setting (preferred)
• Clinical denials experience (preferred)
• EPIC experience is a plus
• Insurance experience

Education Requirements:

GED, High School (Required)

Certification/License Requirements: