Patient Accounts Specialist – Medicaid

About this Job

General Summary of Position IMedStar Health has an opportunity for a Patient Accounts Specialist to join the Patient Accounting Medicaid team. On-site training in Nottingham, Maryland is preferred. After training, associates get to enjoy a remote schedule working full time, Monday — Friday, day shift. We are specifically looking for a candidate that has critical thinking skills along with experience in facility claims follow-up, researching/investigating claim denials and preparing/writing appeals to get claims paid.

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. More About the Medicaid Team – The Medicaid team is responsible for completing the following up on accounts where the patient has straight Medicaid.

We work closely with advocacy, CFC and billing to ensure patients who receive retro-eligible Medicaid are billed timely within the specific state requirements.

• Attends training sessions and workshops offered to include but not limited to CPAT Training bulletin review etc. Attends and successfully completes required Continuing Education Units (CEU) for the PFS Training Program. Completes annual mandatory training (SITEL) within defined time frame.
• 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.

Education

• High School Diploma or GED required

• 1-2 years Experience in patient accounting accounts receivable or related healthcare field required, or an equivalent combination of experience and college education in accounting finance or healthcare administration required

• Detailed working knowledge and demonstrated proficiency in at least one specific payers application billing and/or collection process.
• Requires basic working knowledge of UB04 and Explanation of Benefits (EOB).
• Requires some knowledge of medical terminology and CPT/IDC-9 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.

This position has a hiring range of : USD $18.33 – USD $31.61 /Hr.

Med Star Health