Job description
The Patient Financial Services Specialist performs various functions associated with the billing and collections of hospital inpatient and outpatient accounts, including the accurate and timely submission of claims to third-party payers and follow-up and denial resolution to facilitate maximum reimbursement. Responsibilities include but are not limited to:
- Following up with payers on submitted claims and unresolved balances to ensure timely and accurate payment for services.
- Maintaining a thorough knowledge of payer policies and guidelines and understanding payer websites and resources needed for the submission and resolution of claims.
- Demonstrating understanding of standard billing processes.
- Researching aging receivables for assigned payers.
- Resolving denials and underpayments in a timely fashion.
- Assisting in the identification of payment barriers and system issues.
- High School Diploma or GED required; Associate's Degree in Business or a related field of study preferred
- A minimum of 2 years of experience in a hospital patient accounts environment or medical office setting required
- Thorough understanding of third party insurance carriers, billing requirements and reimbursement methodologies required
- Familiarity with basic medical terminology, CPT4 and ICD-10 required
- Excellent analytical and organizational skills required
WORK SCHEDULE: 40 hours, Monday - Friday, days
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