Patient Accounts Specialist - Nongovernmental Follow-up Job Listing at MedStar Medical Group in Baltimore, MD (Job ID req36550)

Description

MedStar Health has an opportunity for a Patient Accounts Specialist to join the Patient Accounting Non-Gov Follow-up North team with MedStar Patient Financial Services.  As a Patient Accounts Specialist on this team, you will be responsible for Interpreting and evaluating 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.  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.  

About MedStar Patient Financial Services – Patient Accounting Non-Government North Team:
The Non-Governmental Follow Up North Department works all Commercial, HMO, MCO, Medicare Advantage and Workers' Comp payers for 7 MedStar Health hospitals located in Maryland.   The department completes follow-up on accounts that have been billed and either no payment has been received or when only partial payment is received.  The team is also responsible for submitting appeals and payment reconsiderations on denials and underpayments as necessary.

Primary Duties:

·       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.

Qualifications:

·       High school graduation or equivalent.

·       1 year 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. 

·       Detailed working knowledge and demonstrated proficiency in multiple payers application billing and/or collection processes, including governmental and non-governmental.

·       Requires basic working knowledge of UB04 and/or 1500 and Explanation of Benefits (EOB).

·       Requires some knowledge of medical terminology and CPT/ICED-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.