Patient Financial Services is currently seeking a Patient Accounts Specialist join our team in a PRN (per diem) role working with the CFC Verification team.
Position is PRN (per diem) with flexible DAYSHIFT hours, Monday - Friday.
We are specifically looking for a candidate with strong experience and knowledge of insurance verification and insurance authorization.
The CFC Verification team is responsible for handling verification, authorizations, and patient liability estimates for services rendered at all MedStar facilities.
CFC clears accounts for inpatient surgery, outpatient surgery, emergency admission, observation status, and some ancillary services.
Job Summary - Secures insurance benefits, patient liability and authorization for all services designated as CFC responsibility.
Works in a team environment to ensure departmental goals and KPIs are met.
Works closely with Utilization Review to ensure clinical documentation is submitted timely and all days are approved.
Education
High School Diploma or GED requiredExperience
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
Knowledge, Skills, and Abilities
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/ICD-10 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.
Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards.
Complies with governmental and accreditation regulations.
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.
Participates in PFS workgroups, staff meetings and work events.
Participates in multi-disciplinary quality and service improvement teams.
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