MedStar Medical Group Job - 50423267 | CareerArc
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Company: MedStar Medical Group
Location: Baltimore, MD
Career Level: Associate
Industries: Not specified

Description

General Summary of Position

MedStar Patient Financial Services MNRN Follow-up team is currently seeking a Patient Accounts Specialist to join our amazing team.  We are specifically looking for a candidate that has experience with facility and/or physician claims follow-up, researching claim denials and preparing/writing appeals to get claims paid.   

The MNRN Ambulatory – AR Follow-up Department performs the AR follow-up of all payers except Medicare for our therapy facilities. The AR Follow-up responsibility is inclusive of denial management and claim status processes to optimize cash collections. We work together with the clinical administration team to resolve technical and clinical denials.  We also work with our Cash and Billing team to solve issues and develop efficient internal processes. 

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.


Primary Duties and Responsibilities

  • 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.
  • Meets monthly departmental key performance indicators (KPIs) as it applies to open receivable, aged AR, credit balances, and high dollar accounts.
  • Processes and transmits the daily billing upload of electronic claims received into the Payerpath system within the same business day, including completion of the Payerpath Billing Tracking spreadsheet. Accurately assigns claims in the 837 upload to the correct payer and payer identification number.
  • Processes payer reports for reconciliation by 11am daily for all electronic payers. Completes all electronic Payer rejections received by 11 am within 24 hours of receipt. Completes Payerpath Billing Tracking Reconciliation Spreadsheet by end of each business day.

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    Minimum Qualifications
    Education

    • High School Diploma or GED equivalent required

    Experience

    • 1-2 years experience in patient accounting, accounts receivable or related healthcare field required
    • 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/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.


    This position has a hiring range of $18.33 - $29.96

     


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