Patient Account Specialist Senior-Onsite - Temp to Permanent - Sigma Inc

Shift Timings: 8 AM - 5 PM, Monday - Friday

Summary :

• Provides medical collection services for TLRA collection units.
• Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection.
• This involves performing collection activities related to follow-up and account resolution, and includes communication to patients, clients, reimbursement vendors, and other external entities while adhering to all client, state and federal guidelines.
• Patient and client satisfaction is essential.
• Associates in the collection unites are expected to knave knowledge of the overall collection work processes for the both active AR and Client inventory.
• Possesses thorough understanding of the hospital revenue cycle with specialization in hospital billing, follow-up, and the account resolution process.
• Utilizes and applies industry knowledge to resolve aged accounts receivable by working various account types including, but not limited to: hospital and/or professional claims, governmental and/or non-governmental claims, denied claims, high priority accounts, etc.
• Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls in order to ensure prompt payment of medical claims.
• Pursues and/or follow-up on appeals. Initiates communication with coding team and clinical staff when coding related, and medical necessity appeals are warranted.
• Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments. Makes recommendations for resolution.
• Remains open-minded with change: maintains performance during period(s) of change and understands changes in tasks and/or environment as well as the basis for change Possesses ability to professionally communicate (in all forms) with payer resources such as: website, e-mail, telephone, customer service departments, etc.
• Possesses a cooperative and positive attitude toward clients, management, and co-workers by responding politely and professionally and being a valued team player Ability to meet departmental standard for quality and productivity

Requirements:

• College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
• Must have minimum of 3 years' experience in a Customer Service call enter environment with a focus on healthcare billing/collections or collection agency environment or 3 years' experience working in a client service or marketing capacity, preferably in a healthcare or collection agency environment.
• General hospital A/R accounts knowledge is required.
• PC skills in a Windows environment are required.
• Solid knowledge and utilization of desktop applications to include Word and Excel are essential.