- Actively and continuously improves work processes for self. Uses continuous improvement tools and methods to improve individual, team and cross-departmental performance. Bases improvements on customer requirements, data, root-cause analysis and outcomes.
- Assists in creation/implementation of in service training materials and presentation for team development.
- Assists in the planning of work for self and Insurance Specialist, including setting goals, prioritizing work and coordinating the execution of work. Assists supervisor in planning, coordinating and direction of daily work activities of clerical, billing and collection staff. Assists supervision in collection activities and functions.
- Assists with determining organization processes that maximize cash receipts.
- Bills patient accounts and assures accuracy by reviewing and verifying patient charges, coordinating benefit level, type of coverage, and/or approval for coverage.
- Collects insurance accounts by contacting insurance carriers and other third party payers to verify receipt of billing and other information needed to process claims, secure approximate date of payment, negotiate with claims personnel for prompt payment and resolve discrepancies in billings within appropriate time frames.
- Communicates effectively with staff at all levels of organization, both inter and intra-departmentally.
- Contacts and participates in meetings with internal and external customers to resolve difficulty payment or process issues.
- Develops productive relationships with payer representatives to secure timely payment of claims.
- Forwards bill to third party payers, and/or enters billing information into computerized billing system.
- Interprets data and reports to determine work priorities and resource allocation across multiple billing and collection tasks.
- Investigates and resolves insurance claim rejections.
- Meets the Performance ETM Production quota set at 90% of the established quota.
- Participates in educational/professional development activities. Exemplifies Guest and Staff Relations standards in all activities in areas of service, resource utilization, high quality outcomes and effective communication. Provides guidance and instruction to fellow team members when necessary.
- Provides information regarding work progress, actions and issues in a timely and effective manner. Recommends improvements.
- Recommends timely invoice adjustments.
- Reviews and monitors work quantity and quality, recommends the allocation of resources, helping to ensure departmental goals are met or exceeded.
- High School Diploma or GED equivalent required
- Associate degree or Bachelor's degree preferred
- 4 years of progressively responsible experience in hospital/physician patient accounts or equivalent experience required
- Experience and proficiency using an automated billing system, GE IDX and ETM experience
- Effective negotiating skills, to include ability to resolve complex billing and collection situations with individual patients or third party payers.
- Proactive problem solving skills.
- Ability to interpret data and related information, and discern trends and tendencies, as well as determine appropriate course of action.
- Ability to work as part of team, set goals, prioritizes work and assist in the coordination and execution of work.
- Ability to assist in the following areas: lead, monitor daily activities, evaluate, train and motivate performance of team members.
- Effective verbal and written communication skills.
- Knowledge of ETM, basic operation of hardware and work processing and spreadsheet packages, preferably Microsoft.
- Knowledge of relevant billing and collection laws and regulations, hospital protocols.
- Knowledge of third party claims and diagnostic coding, to include ICD 9/10 and CPT coding.
- Demonstrates proven successful organizational and analytical skills that ensure consistent completion of daily quota driven processing.
- Strong emphasis on teamwork - our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
- Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
- Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
- More career opportunities closer to home - as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.
Patient Accounts Specialist II - Baltimore, United States - MEDSTAR HEALTH
Description
General Summary of Position
MedStar Physicians' Billing Services has an opening for an experienced Patient Accounts Specialist (Level II) to join our team and work remote from home To be successful, candidates must have a minimum of four years of experience in hospital/physician patient accounts and collections in medical billing operations.
Join one of the largest health systems in the Maryland, Virginia and Washington, D.C., area and enjoy the benefits of a full benefits package including paid time off, health/vision/dental insurance, short- & long-term disability, tuition reimbursement and the benefits of remote work capability.
Job Description: Under general supervision, performs accounts receivable follow-up/collection procedures to obtain timely reimbursement from third party carriers and other payment sources on moderately complicated invoices in a Direct Contract assignment and/or with an invoice balance. Performs collection activity for assigned divisions, third party carriers and individual providers. Maintains contacts with third party carriers and communicates billing/reimbursement changes to management in a timely manner. Assists in evaluation of A/R and participate in development of collection strategies to decrease outstanding A/R.
Primary Duties and Responsibilities
Minimum Qualifications
Education
Experience
Knowledge, Skills, and Abilities
Why MedStar Health?
At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through:
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.
MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.