Patient Accounts Specialist- Insurance
TypeFull-time job
LocationUnited States
Posted3 hours ago
About Us
We are Emerus, the leader in small-format hospitals. We partner with respected and like-minded health systems who share our mission: To provide the care patients need, in the neighborhoods they live, by teams they trust. Our growing number of amazing partners includes Allegheny Health Network, Ascension, Baptist Health System, Baylor Scott & White Health, ChristianaCare, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS Health, MultiCare and WellSpan. Our innovative hospitals are fully accredited and provide highly individualized care. Emerus' commitment to patient care extends far beyond the confines of societal norms. We believe that every individual who walks through our doors deserves compassionate, comprehensive care, regardless of their background, identity, or circumstances. We are committed to fostering a work environment focused on teamwork that celebrates diversity, promotes equity and ensures equal access to information, development and opportunity for all of our Healthcare Pros.
Position Overview
The purpose of this position is to assist in managing the company’s outstanding receivables, through routine communication with all payers (e.g. commercial insurance, Medicare, private pay patients, etc.) to ensure that expected reimbursement for patient care is processed timely and paid accurately.
Essential Job Functions
Follow up on submitted claims (i.e., claim received, pending, processing, paid, etc.) and complete action as appropriate to ensure timely receipt and appropriate reimbursement
Communicate with payers regarding delinquent or denied claims, addressing issues and clearing barriers to payment
Manage claim details and verify accurate reimbursement, so as to initiate account adjustments and/or appeals on payment disputes
File appeals for denied claims and follow-up as necessary through appeal resolution
Manage and maintain outstanding patient balances to ensure accurate reporting of company’s accounts receivable
Utilize on-line/telephonic resources to verify benefits and ensure claims are processed according to the appropriate benefit levels
Submit refund requests as necessary
Works special projects as assigned by Supervisor/Director/CFO
Other Job Functions
Meet position’s goals and objectives related to accuracy and productivity (e.g. days in AR, cash collections, etc.)
Attend staff meetings or other company sponsored or mandated meetings as required
Perform additional duties as assigned
Willingness and ability to work overtime
Basic Qualifications
High School Diploma or GED, required
2+ years experience in a provider setting (inpatient or outpatient), required
Knowledge of all payors insurance; self-pay after insurance, reimbursements, collections, appeals, claims follow-up and third party billing, required
Experience with medical records or patient accounting systems, required
Knowledge and understanding of state and Federal payment laws, required
Knowledge and understanding of healthcare ‘explanation of benefits’ (EOB’s), required
Experience with a 10-key adding machine, required
Position requires fluency in English; written and oral communication
Originally posted on Himalayas
We are Emerus, the leader in small-format hospitals. We partner with respected and like-minded health systems who share our mission: To provide the care patients need, in the neighborhoods they live, by teams they trust. Our growing number of amazing partners includes Allegheny Health Network, Ascension, Baptist Health System, Baylor Scott & White Health, ChristianaCare, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS Health, MultiCare and WellSpan. Our innovative hospitals are fully accredited and provide highly individualized care. Emerus' commitment to patient care extends far beyond the confines of societal norms. We believe that every individual who walks through our doors deserves compassionate, comprehensive care, regardless of their background, identity, or circumstances. We are committed to fostering a work environment focused on teamwork that celebrates diversity, promotes equity and ensures equal access to information, development and opportunity for all of our Healthcare Pros.
Position Overview
The purpose of this position is to assist in managing the company’s outstanding receivables, through routine communication with all payers (e.g. commercial insurance, Medicare, private pay patients, etc.) to ensure that expected reimbursement for patient care is processed timely and paid accurately.
Essential Job Functions
Follow up on submitted claims (i.e., claim received, pending, processing, paid, etc.) and complete action as appropriate to ensure timely receipt and appropriate reimbursement
Communicate with payers regarding delinquent or denied claims, addressing issues and clearing barriers to payment
Manage claim details and verify accurate reimbursement, so as to initiate account adjustments and/or appeals on payment disputes
File appeals for denied claims and follow-up as necessary through appeal resolution
Manage and maintain outstanding patient balances to ensure accurate reporting of company’s accounts receivable
Utilize on-line/telephonic resources to verify benefits and ensure claims are processed according to the appropriate benefit levels
Submit refund requests as necessary
Works special projects as assigned by Supervisor/Director/CFO
Other Job Functions
Meet position’s goals and objectives related to accuracy and productivity (e.g. days in AR, cash collections, etc.)
Attend staff meetings or other company sponsored or mandated meetings as required
Perform additional duties as assigned
Willingness and ability to work overtime
Basic Qualifications
High School Diploma or GED, required
2+ years experience in a provider setting (inpatient or outpatient), required
Knowledge of all payors insurance; self-pay after insurance, reimbursements, collections, appeals, claims follow-up and third party billing, required
Experience with medical records or patient accounting systems, required
Knowledge and understanding of state and Federal payment laws, required
Knowledge and understanding of healthcare ‘explanation of benefits’ (EOB’s), required
Experience with a 10-key adding machine, required
Position requires fluency in English; written and oral communication
Originally posted on Himalayas
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