Job: Patient Accounting Specialist

To promptly file provider and hospital claims (inpatient and outpatient) with third party payers, to follow up in a timely and efficient manner, and to ensure maximum reimbursement is received for services provided. To assist the public in resolving billing issues and to understand billing procedures.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

Process and transmits assigned claims within a timely and efficient manner. Perform all associated duties in order to ensure completeness/correctness of all claims information for maximum reimbursement

Analyze, update and correct claims data according to established procedures. Input data accurately and consistently, prioritizes work to maximize cash flow; demonstrate thorough knowledge of third party payers’ claims requirements for CMS 1500 and UB92

Handle phone, mail and personal inquiries from the public regarding patient accounts; assist each person promptly and courteously; follow through on all issues requiring action as a result of the inquiry

Work with Center staff to identify problems or concerns that delay real-time and accurate claims processing

Follow department procedures, observe confidentiality, maintain all documentation according to Federal/State regulation, take an active role in departmental meetings and participate as a team member in resolution of problems

Provide reports and information to Patient Accounting Manager and Patient Accounting analyst as needed for month end close, analysis or other purposes

Assist with training center and other staff as needed

Working knowledge of telephone system and telephone protocol

Understand and participate in Joint Commission continual readiness

Work with the Clinical Services Department to promote ongoing performance improvement activities

Participates in all safety programs which may include assignment to an emergency response team

Perform other duties as assigned or become necessary by supervisor


PRIORITIES SERVED

• Accuracy
• Customer Service
• Organization
• Timeliness
• Effective Communication
• Initiative and Creativity
• Reliability
• Professionalism


SUPERVISORY RESPONSIBILITIES
None at this time.

DESIRABLE QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


• Associate degree
• One (1) year billing/claims processing experience.
• Strong computer skills with knowledge of Microsoft Word, Excel, and Performance Management Systems.
• Excellent work history with proven track record.
• Excellent data entry skills—accuracy is very important.
• Excellent communication skills.
• Ability to pass pre-employment drug test.
• Professional, clean, neat appearance.
• No convictions of serious crimes or felonies.
• Must be willing to travel to other medical sites within Wake Health Services, Inc., to assist other facilities.



COMMUNICATION SKILLS

• Ability to read and comprehend general instructions, correspondence, and memos.
• Ability to read and interpret general business periodicals.
• Ability to write reports and business correspondence.
• Ability to effectively present information and speak before groups of employees and outside consultants and respond to questions/comments from the same.

OTHER NECESSARY SKILLS

• Ability to work independently. Ability to take initiative and be a self-starter.
• Ability to plan and organize workload. Ability to handle very detailed information.
• Ability and flexibility to handle work pressure and work with interruptions.
• Ability to meet work processes deadlines.
• Ability to handle multiple priorities.
• Ability to function as a team player.
• Ability to effectively communicate with employees, patients, vendors, consultants, and auditors.
• Willing to learn and accept responsibility.
• Ability to work flexible hours as needed.
• Ability to interact in a professional manner with employees, patients and vendors.
• Ability to communicate clearly and effectively. Excellent oral, written, and listening skills.
• Ability to secure information from inter-department personnel.