Patient Accounting Collections Specialist

Presbyterian Healthcare Services is a not-for-profit healthcare system focused on improving the health of patients, members, and communities. The Patient Accounting Collections Specialist follows up on, collects, and resolves outstanding accounts receivable while managing claims, communicating with payers and patients, documenting accounts, and ensuring timely reimbursement in compliance with organizational and CMS requirements.

What you'll do:

• Performs accounts receivable follow-up activities for their assigned work queues and/or miscellaneous A/R reports
• Responsible for contacting insurance companies, patients, and employers regarding outstanding claims
• Responsible for providing any information (medical records, itemized statements, etc) requested by insurance companies to process claims
• Must maintain a system to ensure timely follow up is completed for each outstanding claim
• Responsible for identifying and reporting insurance payor issues to lead, providing all pertinent information to include examples, correspondence, EOBs, claims, etc
• Consult with lead regarding next steps with difficult claims
• Must communicate all issues to teammates and Follow-up & Collection Supervisor
• Refer accounts, in accordance with PHS guidelines, to leadership for adjustment, agency placement or attorney referral
• Cross train in the various Patient Accounting Department areas to be completely familiar with all aspects of patient accounting functions as they relate to collections
• Perform other duties as assigned by the Follow-up & Collection Supervisor and/or Manager
• Document accounts in accordance with established PHS policies and procedures
• Effectively operates and is familiar with various computer systems. These may include the following: Epic, FinThrive, FISS/DDE, Presbyterian Health Plan Provider Portal, Payer portals, Microsoft Office Suite

What they're looking for:

• High School diploma or GED
• Excellent organizational, problem-solving, verbal and written communication skills, along with, attention to detail and the ability to interact effectively with other functional areas and management teams
• Must have a strong work ethic and demonstrated ability to work effectively in a team environment
• Must be able to prioritize and manage a high-volume, workload
• Must be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements
• Must have basic knowledge of various payer requirements, claim submission processes for major insurances carriers and intermediaries
• Must have basic knowledge of the revenue cycle processes
• Less than 1-year healthcare clerical or customer service experience
• Experience with Microsoft Office Suite products
• Basic knowledge of ICD-10, HCPCS, CPT codes, Revenue Codes, UB04 and HCFA 1500 claim forms and an understanding of electronic processing of 837 and 835
• Basic knowledge of Coordination of benefits and the Medicare MSPQ

Benefits:

• Medical insurance for benefits-eligible Presbyterian employees
• Dental insurance for benefits-eligible Presbyterian employees
• Vision insurance for benefits-eligible Presbyterian employees
• Short-term disability insurance for benefits-eligible Presbyterian employees
• Long-term disability insurance for benefits-eligible Presbyterian employees
• Group term life insurance for benefits-eligible Presbyterian employees
• Other optional voluntary benefits for benefits-eligible Presbyterian employees
• Employee Wellness rewards program, including gift cards and other rewards for participating in wellness activities
• Virtual work arrangement