Apply on Employer Site

Augusta Health · 1 month ago

Patient Financial Services (PFS) Account Specialist (Accounts Receivable Clerk (Healthcare), Patient Accounts Rep, Patient Billing Coordinator)

Fishersville, VA

Full-time

Onsite

New Grad, Entry Level

0+ years exp

Augusta Health is an independent, nonprofit, mission-driven health system located in Fishersville, Virginia. The Patient Financial Services (PFS) Account Specialist will provide support in patient accounting, focusing on billing and collection activities to optimize cash flow and ensure prompt account resolution.

Health CareHospitalNon Profit

Responsibilities

Provide organizational support for the hospital and/or medical group in the patient accounting role through clean and accurate billing and collection activity to ensure prompt account resolution and cash flow optimization on hospital and/or physician accounts receivables management

Support and seek to achieve departmental goals

Work daily tasks generated within any/all of the departments receivables management computer systems including assigned pre billing edit rejected claims and unpaid denied claims through identifying, documenting and following up on problematic issues that prevented the successful and timely transmission of accurate/clean claims by a third party support partner as well as following up on denied claims by governmental and other third-party payers as assigned in the work queue

Identify and resolve invalid or missing claim data by communicating with the physician office practices, hospital clinical departments, compliance representatives, billing support personnel and/or other constituents to secure and correct the data which prevents or compromises the accurate transmission of the claim to the payer

Knowledge of the appeals process in researching denied claims to resolve discrepancies and correct claim data for re-billing

Oversee assigned accounts receivable to ensure claims are being processed to completion through the following methods: Proactively generating aging reports through the appropriate billing system

Processing of unclean claims in a timely manner in the claims scrubbing system

Accurate and timely follow up on unresolved claims through communications with third party payers and patients, including electronic and verbal communication channels

Trouble shoot issues that surface to ensure timely resolution

Monitor claims for denial trends and inform all parties involved including: Management, Office staff, Physicians, Department leaders, And Revenue Cycle leadership

Maintain a working knowledge of all payer standard transactions sets, such as: 837 electronic claims processes, 835 electronic remittances processes and code sets, Electronic fund transferring, to ensure timely deposits of electronic payments

Ensuring Timely Accounts Resolution And Optimization Of Cash Flow

Knowledge of the appeals process in researching denied claims to resolve discrepancies and correct claim data for re-billing

Maintain working knowledge of multiple systems used in the day-to-day functions of the centralized business office

Prompt response to payer and patient correspondence

Provide regular feedback to management related to payer issues, provider office issues, and any other issues that will delay payment of claims

Ability to understand trends versus one off situations that may become a pattern

Keeping informed of new federal and state billing regulations any guidelines and report any issues to leadership

Meets productivity standards as set by departmental policy in the areas of quantity of work and quality of work

Other duties as assigned by Hospital and Physician Billing Manager, or Patient Accounting Director

Qualification

Accounts Receivable ManagementBillingCollection TechniquesClaims ProcessingMedicalAccounting ExperienceAppeals ProcessMicrosoft Office ProficiencyCommunication SkillsProblem SolvingTime ManagementAdaptability