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Company: MedStar Medical Group
Location: Baltimore, MD
Career Level: Associate
Industries: Not specified

Description

General Summary of Position
MedStar Health is currently seeking a dedicated Patient Accounts Specialist to join our Patient Accounting NRN Ambulatory Follow-up Team, supporting MedStar Physical Therapy outpatient offices.  We are specifically looking for a candidate that has experience with thorough denial research and preparation of appeals to secure timely reimbursement.   Knowledge of ICD-10 and/or principal diagnosis code rules is a HUGE PLUS!!

This team performs the AR follow-up of all payers except Medicare for our therapy facilities. The AR Follow-up responsibility is inclusive of denial management and claim status processes to optimize cash collections. We work together with the clinical administration team to resolve technical and clinical denials.  We also work with our Cash and Billing team to solve issues and develop efficient internal processes. 


Primary Duties and Responsibilities

  • Keeps abreast of regulatory and specific changes as it relates to billing requirements and payer specific follow up
  • Maintains daily performance benchmarks as it applies to interpreting and evaluating appeals to include follow up with payers. Completes coding report updates within the standard set in a timely manner to begin the daily workflow process. Responsible for reconciliation of reports to SMS and information that was posted.
  • Maintains departmental QA standard within established error rate.
  • Meets team specific benchmark as it applies to completed Tracking Forms forwarded to the Operational Desk after completion on a daily basis, >$10K, >$20K, AR15, AR30, and AR45.
  • Participates in PFS workgroups, staff meetings and work events.
  • Participates in multi-disciplinary quality and service improvement teams.
  • Meets monthly departmental key performance indicators (KPIs) as it applies to open receivable, aged AR, credit balances, and high dollar accounts.

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    Minimum Qualifications
    Education

    • High School Diploma or GED required

    Experience

    • 1-2 years' Experience in patient accounting, accounts receivable or related healthcare field required or an equivalent combination of experience and college education in accounting, finance or healthcare administration required

    Knowledge, Skills, and Abilities

    • Detailed working knowledge and demonstrated proficiency in at least one specific payers application billing and/or collection process.
    • Requires basic working knowledge of UB04 and Explanation of Benefits (EOB).
    • Requires some knowledge of medical terminology and CPT/ICD-10 coding.
    • Excellent communication, analytical, interpersonal, and organizational skills.
    • Proficient uses of hospital registration and/or billing systems and personal computers as well as Microsoft Excel and Word applications.
    • Ability to type 35 WPM.


    This position has a hiring range of $18.33 - $31.61

     


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