General Purpose:
This position is critical to the success of the revenue cycle. Bill and collect payments for services rendered from a variety of payor sources. The Patient Accounts Billing Specialist is responsible for timely and accurate coding, billing, claim denials, and payment posting.
Essential Duties and Responsibilities:
- Resolve issues with incomplete and/or inaccurate patient registration
- Verify charges were entered correctly and update as needed.
- Work aged receivables utilizing A/R reports/functionality in revenue cycle management (RCM) module
- Review and assess adjudicated claims for timely and proper payment of outstanding balances
- Research, correct and resubmit or reprocess unpaid claims as necessary
- Verify validity of account balance by researching, reviewing, and ensuring accuracy or payment and adjustment posting
- Review and interpret explanation of benefits (EOB) for denials and reimbursement underpayments
- Research and resolve denials and underpayments with insurance carriers
- Submit third party payor appeals and reconsideration requests in a timely manner
- Meet department and/or organization productivity goals/benchmarks
- Post third party payors(s), government, grant funded and patient payments
- Respond to patient inquiries regarding billings
- Assist other staff as needed to keep department workload current
- Maintain communication with all interested parties regarding patient account issues
- Perform other duties as assigned
