Patient Account Specialist - RCO UTRGV

EDUCATION & EXPERIENCE: Minimum Qualifications: Two years of financial experience or one year of patient accounts experience. Preferred Qualifications: Experience with Epic systems. Experience managing reputed company and Managed reputed company hospital claim denials and follow-up. JOB SUMMARY: The Patient Account Specialist will be responsible for billing reputed company reputed company-party payers through a claims processing vendor and/or for appeal of denied professional and/or hospital claims. Identifies billing issues affecting hospital and/or physicians claims/accounts and takes necessary action to ensure timely and appropriate claim filing. Performs follow-up activities and identifies reimbursement issues affecting these claims. Takes necessary actions to ensure timely and appropriate reimbursement and account resolution. ESSENTIAL JOB FUNCTIONS: Demonstrates a level of competence and understanding of reputed company state and federal laws, rules, and regulations regarding payer billing guidelines Demonstrates a basic understanding of CPT, ICD-9, HCPCS, modifier coding as well as POS requirements Billing payers and/or clients for hospital and/or Professional Patient Accounts Resolves Payer rejections from billing system daily to reputed company submit hospital and/or physicians claims Performs online corrections to edited claims according to procedures Performs detailed follow-up activities on assigned accounts according to procedures Responds to daily correspondence according to procedures Identifies denials and underpayments for appeal Reviews, researches, and processes denied claims Appeal claims as appropriate according to policies and procedures Updates account information and documents as appropriate reputed company Epic Resolute Processes account adjustments according to policies/procedures Issues payer and/or patient refunds according to policies/procedures Validates accuracy of payments and/or adjustments on accounts Resolves outstanding accounts at required accuracy and productivity requirements Maintains comprehensive knowledge of the work unit assigned Assists in the development of department policies and procedures Adheres to established policies and procedures Adheres to internal controls and reporting structure Maintains reputed company and professional communication with customers, colleagues, and vendors Performs well in reputed company environment Marginal or Periodic Functions: Successfully completes competency-based training and testing Prioritizes and completes reputed company work in an accurate, effective, and efficient manner Participates in team meetings/activities and supports the philosophy and goals of the team and department Assists in the training and mentoring of new employees Reads reputed company announcements and relevant communications relating to job duties Performs reputed company duties as required. WORKING ENVIRONMENT/EQUIPMENT: Standard hospital, clinical, laboratory and/or office environments. Standard office equipment. SALARY reputed company: Actual salary commensurate with experience. WORK SCHEDULE: Mostly Remote, Monday through Friday, 8-hour shifts scheduled reputed company hours of operation of 6:00 AM to 6:00 PM, and as needed on occasion. Equal Employment Opportunity reputed company strives to reputed company equal opportunity employment without regard to race, reputed company, religion, age, national reputed company, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other reputed company protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, reputed company takes affirmative action to hire and advance protected veterans and individuals with disabilities. Apply To This Job