Overview
An experienced Patient Accounts Specialist is needed to join a Patient Accounting team supporting non-governmental follow-up for hospitals in Washington DC. This role focuses on facility and/or physician claims follow-up, denial resolution, and appeals processing to ensure timely and accurate reimbursement.
Responsibilities
- Perform follow-up on accounts that have been billed but have not received payment or have received partial payment.
- Issue written appeals for denied claims.
- Manage accounts across various payers including Commercial, Blue Cross, HMO, MCO, Medicare Advantage, and Workers’ Compensation.
- Maintain familiarity with contract-based reimbursement systems for each payer and facility.
- Interpret and evaluate appeals, including follow-up with payers to ensure timely claims resolution and reimbursement.
- Interpret explanation of benefits and understand payer methodologies.
- Keep current with regulatory and billing requirement changes.
- Maintain daily performance benchmarks related to appeals and follow-up activities.
- Complete coding report updates promptly to support daily workflow.
- Reconcile reports to system data and posted information.
- Maintain departmental quality assurance standards within established error rates.
Requirements
Education
- High School Diploma or GED required.
Experience
- 1-2 years of experience in patient accounting, accounts receivable, or a related healthcare field, or an equivalent combination of experience and college education in accounting, finance, or healthcare administration.
Knowledge, Skills, and Abilities
- Detailed working knowledge and demonstrated proficiency in at least one specific payer's billing and/or collection process.
- Basic working knowledge of UB04 forms and Explanation of Benefits (EOB).
- Some knowledge of medical terminology and CPT/ICD-10 coding.
- Excellent communication, analytical, interpersonal, and organizational skills.
- Proficient in hospital registration and/or billing systems, personal computers, and Microsoft Excel and Word.
- Ability to type 35 words per minute.
Compensation
- Hourly pay range: USD $18.70 - USD $32.72 per hour.
Location
- Washington DC area hospitals.