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

Description

MedStar's Patient Financial Services is currently seeking a Patient Accounts Specialist to join our Guarantor Team.  Position may require on-site training in the business office located in Nottingham, Maryland.  Remote position after training. 

Monday - Thursday, 7am - 3:30pm, remote schedule 

The Guarantor Team is responsible for the billing and follow up of claims for our guarantor population as well as the follow-up for the specialty insurance plans.  The Guarantor Plans include a variety of payers such as Kidney Acquisition, National Kidney Registry, Catholic Charities and numerous state grants.  The specialty plans include payers such as the Veterans Administration, Tricare and Policy and Fire Clinic.  Claims are billed via UB04 or List Billing.

Job Summary
 Interprets and evaluates appeals to include follow-up with payers to assure timely turn around for claims resolution and reimbursement. Must be able interpret explanation of benefits and have a clear understanding of payer methodology. Works in a team environment.


Education
  • High School Diploma, GED or equivalent required
Experience
  • 1-2 years Experience in patient accounting, accounts receivable or related healthcare field, 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/IDC-9 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.
  • Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
  • Attends training sessions and workshops offered, to include but not limited to, CPAT Training, bulletin review, etc. Attends and successfully completes required Continuing Education Units (CEU) for the PFS Training Program. Completes annual mandatory training (SITEL) within defined time frame.
  • Keeps abreast of regulatory and specific changes as it relates to billing requirements and payer specific follow up.
  • Maintains departmental level II QA standards within established error rate.
  • Participates in PFS workgroups, staff meetings and work events.
  • Processes and completes the daily billing workload of electronic claims received into the Caremedic billing system within the same business day, including completion of the Billing Tracking Spreadsheet.
  • Processes PXP423 report within 72 hours to ensure all billing is completed by the end of the week.
  • Processes secondary claims and forwards to the appropriate department within 1 hour of time printed on the Accelerated Secondary Report.
  • Processes ZMSP report within 72 hours of receipt to ensure all billing is completed by the end of the week.
  • Successfully conducts and completes new employee training. New hire should be within departmental standards within 6 weeks based on audit results.
  • Within 48 hours, updates modifier spreadsheet with new patients that need modifier coding from hospital department.
  • Participates in multi-disciplinary quality and service improvement teams.
  • Maintains daily performance benchmarks as it applies to Medicare follow-up on outstanding receivables.
  • Meets team specific benchmark as it applies to PXPAID, Disputed Claims, >$10K, >$20K, and credits.

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