Patient Account Specialist II Job

Children's Health - Finance Careers

Job Number: 50512

Location: Dallas, TX

Date Posted: 2-15-2017

Description:

Position Summary

Responsible for the provision of complex patient accounting activity to facilitate efficient operations, expeditious reimbursement and optimal customer satisfaction.

Essential Duties and Responsibilities

Qualifications

  • Is skilled in a range of processes, procedures and systems to carry out assigned tasks or has developed deep skills in a single area
  • Understands the roles of all immediate team members and has a good understanding of how own team integrates with others
  • Regularly provides guidance and support to more junior team members on challenging problems; helps them balance their workload and apply their skills
  • Provides solutions to problems in situations that are atypical or occur infrequently based on practice and existing precedents
  • Impacts the quality, timeliness and effectiveness of the team
  • Uses discretion to modify work practices and processes (but not policies or procedures) to achieve results or improve efficiency
  • Clearly and accurately conveys complex information
  • Performs complex billing and collection activity including resolving complex claim edits and denied claims.
  • Resolves complex patient issues and assists with questions on reimbursement.
  • Participates and provides significant input for and assistance with the implementation of team-oriented process improvement initiatives.
  • Provides solutions to problems in situations that are atypical or occur infrequently based on practice and existing precedents.
  • Possess the ability to interpret and demonstrate compliance with third party contracts, regulations, guidelines, policies and procedures.
  • Demonstrates "The Children's Way" values and behavioral standards.
  • Review all assigned accounts to ensure that all information, codes, and other relevant information is correct and charges have been billed within guidelines.
  • Edit and process claims efficiently, identify errors and/or rejects and resolve billing problems.
  • Follow-up on all billed claims in a timely manner to ensure accurate, timely payment and disposition of account according to the payer contract or guidelines.
  • Coordinates and consolidates payer specific reimbursement data to resolve denials and underpayments by payers.
  • Follow-up with guarantors regarding account status; determine appropriate disposition of the account according to policies and procedures.
  • Review and resolve credit balance accounts in a timely manner.
  • Answer questions concerning complex procedures and serve as a resource to collection coordinators as needed, including on-the-job training for one to two processes or systems.

Education

  • High school diploma or equivalent, required
  • Two-year Associate's degree or equivalent experience, required

Licenses & certifications

  • HFMA Certified Revenue Cycle Representative, preferred

Experience

  • Two to three years of healthcare experience, required
  • Two years of customer service experience, required
  • Knowledge of general procedures and guidelines used by health insurance companies, government agencies, employer benefit departments, and internal departments as they relate to billing and collections, required
  • Excellent mathematical skills, computer skills, Microsoft applications and word processing programs skills and minimum of 40 words per minute, required
  • Ability to develop and maintain productive working relationships to fully integrate within a team, required
  • Proficient in English, written and verbal communication skills, required

Specific knowledge, skills, and abilities

  • Maintain effectiveness when experiencing major changes in work responsibilities or environment; adjust effectively to work within new work structures, processes, requirements, or cultures.
  • Use appropriate interpersonal styles to establish effective relationships with customers and internal partners; interact with others in a way that promotes openness and trust and gives them confidence in one's intentions.
  • Ensure that the customer perspective is a driving force behind business decisions and activities; craft and implement service practices that meet customers' and own organization's needs.
  • Develop and use collaborative relationships to facilitate the accomplishment of work goals.
  • Identify and understand issues, problems, and opportunities; compare data from different sources to draw conclusions; use effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.
  • Take prompt action to accomplish objectives; take action to achieve goals beyond what is required; be proactive.
  • Deal effectively with others in an antagonistic situation; use appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
  • Effectively manage one's time and resources to ensure that work is completed efficiently.
  • Accomplish tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
  • Set high standards of performance for self and others; assume responsibility and accountability for successfully completing assignments or tasks; self impose standards of excellence rather than having standards imposed.
  • Assimilate and apply new job-related information in a timely manner.
  • Clearly convey information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message.

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