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

Description

MedStar Health's Patient Accounting Medicare Team is currently seeking an experienced Patient Accounts Specialist to join our amazing team.  We are specifically looking for candidates who have experience with claims follow up and the ability to read/interpret an explanation of benefits. This position is full time, Monday - Friday dayshift, working remotely after on-site training in Nottingham, Maryland (up to the first 90-days).

More About the Medicare Team:  The Medicare Team is responsible for billing all Medicare claims, as well as the AR follow up. Medicare handles all their own claims from start to finish. We work closely with Novitas and with various internal PFS Departments to ensure claims are billed and paid timely and correctly. This requires us to stay current with all Medicare Federal Guidelines. We work our own credits and PX as well.

Job Summary - To ensure timely payments, initiates follow-up on outstanding receivables by contacting Medicare or utilizing the on-line system. Work must meet QA standards to ensure that both departmental and PFS benchmarks are met.

Qualifications:

  • High School Diploma or GED required
  • 1-2 years' experience in patient accounting, accounts receivable or related healthcare field required or an equivalent combination of experience and college education in accounting, finance or healthcare administration
  • 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/ICD-10 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.

Education
  • High School Diploma, GED or equivalent required
Experience
  • 1-2 years Experience in patient accounting, accounts receivable or related healthcare field required, 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 daily performance benchmarks as it applies to interpreting and evaluating appeals to include follow up with payers. Completes coding report updates within the standard set in a timely manner to begin the daily workflow process. Responsible for reconciliation of reports to SMS and information that was posted.
  • Maintains departmental QA standard within established error rate.
  • Meets team specific benchmark as it applies to completed Tracking Forms forwarded to the Operational Desk after completion on a daily basis, >$10K, >$20K, AR15, AR30, and AR45.
  • Participates in PFS workgroups, staff meetings and work events.
  • Participates in multi-disciplinary quality and service improvement teams.
  • 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.
  • 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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