patient account specialist

Winona Health

<div>Patient Account Specialist 
Business Services Department 
1.0 FTE, 80 Hours a Pay Period
 
Days, Hours between 8 am &ndash; 4:30 pm 
Weekends: No 
Holidays: No 
Telecommute Available: No

Position Overview:

The Patient Account Specialist is responsible for manage customer inquiries by multiple communication methods, address billing questions and issues, and collect payments from patients or clients in a timely and professional manner. This role combines customer service with collections duties, ensuring that outstanding accounts are handled efficiently while maintaining positive relationships with patients and clients. The representative is expected to provide exceptional customer service while meeting performance goals related to collections.

Essential Duties &amp; Responsibilities:

Customer Service:
<ul>
<li>Serves as the primary point of contact for patients, clients and insurance representatives through multiple communication methods such as but not limited to phone calls, emails, patient portal and live chat and occasionally in-person.</li>
<li>Provides accurate information regarding billing inquiries about charges, account balances, and payment options and plans, processing payments and directs complaints to the appropriate staff based on the issues being addressed.</li>
<li>Update and maintain accurate patient records in the healthcare system&rsquo;s database, including personal information, demographics, insurance details and conversations.</li>
<li>Collaborate with other business office staff to resolve issues related to incorrect charges, payments or insurance claims.</li>
<li>Maintains a high level of professionalism and empathy while dealing with customers even in difficult situations.</li>
</ul>
Collections:
<ul>
<li>Contacts patients with overdue balances through multiple communication methods such as but not limited to phone calls, emails, patient portal and live chat.</li>
<li>Set up payment arrangements within the payment plan policy.</li>
<li>Follows up with patients who have expired or denied payments from automated payment reminders.</li>
<li>Monitors collections queues to ensure accounts which are past due follow the collection process and issue the required notices by law related to the Fair Debt Collection Practices Act are provided to patients before they are sent to a collection agency.</li>
<li>Collaborate with management to resolve difficult collection issues and escalate as necessary. Report on collection performance and any significant issues or trends to management.</li>
<li>In addition to the responsibilities described above, the role may include other duties and responsibilities as assigned, based upon Winona Health&rsquo;s needs or requirements.</li>
</ul>
Supervisory Responsibilities:

No direct reports

Skills and Experience:

Required:
<ul>
<li>Associates Degree or equivalent experience in a customer service, collections, or related field</li>
<li>Strong communication skills both verbal and written, with the ability to handle difficult situations calmly and professionally</li>
<li>Strong problem-solving skills and detail-orientated with strong organizational skills</li>
<li>Ability to meet deadlines and performance targets</li>
<li>Advanced time-management and organizational skills to handle multiple priorities with shifting timeframes</li>
<li>Proficient use of Microsoft Teams, Word, Outlook, &amp; Excel</li>
<li>Discretion and good judgement in responding to questions by patients, providers, and other professional personnel</li>
<li>Must possess effective customer service oriented communication skills</li>
<li>Professional and respectful attitude, maintaining confidentiality information in compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations, ensuring patient privacy, and data security</li>
</ul>
Preferred:
<ul>
<li>Previous billing and/or collection experience</li>
<li>Bilingual in English and Spanish is preferred but not required</li>
</ul>
Summary of Benefits at Winona Health:

At Winona Health, we are dedicated to offering a comprehensive and affordable benefits package for our employees and their families. While benefits may vary based on employment classification and job status, the following key benefits are available:

Health Insurance: Options for medical, dental, and vision coverage, as well as mental health support and wellness incentives 
Income Protection: Short and long-term disability, plus additional benefits like accident, critical illness, hospital indemnity, legal assistance, and identity protection plans 
Retirement Planning: Access to a 403(b) retirement plan with employer contributions once eligibility requirements are met 
Work/Life Balance: Flexible scheduling, paid time off, and earned sick time to support personal well-being 
Education &amp; Development: Paid training, tuition reimbursement, scholarships, and sponsored seminars to foster both personal and professional growth 
Employee Discounts: Special offers with local businesses, including the YMCA and cell phone providers

For more details or specific information, visit our website or contact Human Resources

Internal Applicant Policy:

It is the policy of Winona Health to work with employees in an equitable fashion regarding promotions, transfers, and position reclassifications.
 
 
Any employee wishing to apply for another available position at Winona Health must submit an application for consideration through the internal application portal. Employees requesting to change positions should have successfully completed at least six (6) months in their current position. Employees currently in the formal disciplinary process may be required to meet with the Director of Human Resources to determine eligibility to request transfer. The employee&rsquo;s past performance, experience, training and qualifications will be considered in transfer/hiring decisions. Consideration for transfer or promotion is not a guarantee of transfer or promotion. Employees may be given a chance to interview for a position when they meet the minimum position qualifications.

Disclaimer:

Winona Health is an equal opportunity employer. Winona Health does not refuse to hire, discharge, or discriminate against a person with respect to tenure, compensation, terms, upgrading, conditions, facilities, or privileges of employment because of race, color, creed, religion, sex, age, national origin, marital status, genetic information, status with regard to public assistance, membership in a local discrimination commission, sexual orientation, disability, veteran status, or any other prohibited basis of discrimination under applicable local, state, or federal law. Winona Health does not tolerate retaliation against any employee, patient/resident, physician, or other individuals pursuing concerns regarding Civil Rights issues. Winona Health adheres to ALL pertinent governmental policies and legislation including the Civil Rights Act of 1964, Title VII, as amended, and the Minnesota Human Rights Act.</div>

Patient Account Specialist

North East Medical Services

<div>SUMMARY OF POSITION: 
The Patient Account Specialist I interprets EOBs for correct payment verification, adjustments, and denials. The Patient Account Specialist I is also responsible for handling outstanding claims on aging reports and resolving patient inquiries regarding billing statements and insurance overage-related matters. The Patient Account Specialist I has to maintain up-to-date knowledge about CPT, ICD-10 CM, billing regulations, and payers' requirements. The Patient Account Specialist I has to comply with HIPAA guidelines and maintain confidentiality regarding patient account status and the organization's financial affairs.
<h1 class="jobSectionHeader">ESSENTIAL JOB FUNCTIONS:</h1><ul><li>
Reviews, edits, processes, and submits electronic and hardcopy claims to various payers (Medicare, Medicaid, Managed Care, and Private Insurance) for FQHC (Federally Qualified Health Centers) and FFS (Fee-For-Service) reimbursement, ensuring accuracy of payment entries and completeness of charge capture information.</li><li>
Maintains up-to-date knowledge of medical billing requirements for FQHC Medi-Cal, Medicare, state, local programs, and private insurance payers.</li><li>
Reports issues or payment trends (e.g., charges applied to the wrong visit, incorrect billing codes) to the supervisor for resolution.</li><li>
Edits charge/claim details and corrects submission errors to ensure accuracy.</li><li>
Researches and resolves outstanding claims on aging reports to minimize delays in reimbursement.</li><li>
Responds to payer requests and remittance advices promptly and professionally, including phone calls, letter responses, appeals, and submission of medical records or additional information as required.</li><li>
Under the guidance of the Patient Account Specialist II, addresses patient inquiries and billing complaints by making necessary adjustments, exploring all options to secure claim payments, referring complex issues to appropriate staff, and ensuring proper follow-up.</li><li>
Posts charges and submits claims for NEMS physicians&rsquo; hospital visits.</li><li>
Provides training and support to the Billing Department and front desk staff in Member Services, Medical, Dental, Optometry, Laboratory, and Radiology Departments.</li><li>
Adheres to policies and procedures for billing records retention.</li><li>
Acts as a liaison between physicians, insurance companies, and third-party organizations by processing and verifying invoices, ensuring claim reimbursements, and auditing patient accounts.</li><li>
Performs additional duties as assigned by management.</li></ul><h1 class="jobSectionHeader">
</h1><ul><li>Completion of an AA/AS degree is required, and a 4-year university diploma is preferred or maybe substituted with a minimum of 3 years of work experience in healthcare.
</li><li>Working experience in a healthcare or FQHC setting is preferred</li><li>
Working experience with Epic PB Resolute is preferred</li><li>
Familiar with Medicare, Medicaid, Private insurances, Managed Care (HMO &amp; PPO), CPT, and ICD-10 CM</li><li>
Must have excellent analytical and communication skills</li><li>
Must be proficient in computer skills</li><li>
Ability to write business correspondence</li><li>
Strong organizational skills to coordinate multiple, varied billing processes simultaneously</li><li>
Upholds high customer service standards in a demanding and complex health care organization</li><li>
Demonstrates initiative, resourcefulness, integrity and dedication to timeliness to achieve high customer satisfaction levels</li>
Self-motivated, diligent, organized, resourceful, responsible, and enthusiastic 
<li>
</li></ul>LANGUAGE:<ul><li>
Proficient in written and spoken English and Chinese (Cantonese and/or Mandarin)</li>
Fluent in other languages is an asset 
<li>
</li></ul>STATUS:<ul><li>
This is an FLSA Non-exempt position.
</li><li>This is not an OSHA high-risk position.</li>
This is a Full Time position. 
<li>
</li></ul>NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).</div>

PATIENT ACCOUNT SPECIALIST I

CHRISTUS Health

<div>Description 
Summary:
Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction is essential. Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and BD inventory.
Responsibilities: 
<ul><li>Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.</li><li>
Provides effective collection services, ensuring the successful recovery of accounts in accordance with client and state guidelines as well as TLRA&rsquo;s business objectives.</li><li>
Documents and updates patient account information in TLRA&rsquo;s collection software system timely and accurate to include appropriate account status.</li><li>
Handles inbound patient and/or carrier calls promptly and professionally, providing assistance and resolution to account inquiries, issues, and requests.</li><li>
Uses collection tools effectively to ensure quality recovery services and meet or exceed established goals and work standards.</li><li>
Performs research and analysis of account issues and strives to resolve problems timely and accurately.</li><li>
Ensure daily productivity standards are met.</li><li>
Promotes positive patient relations by communicating in a manner that demonstrates respect for the human dignity of patients and/or their families.</li><li>
Must have solid knowledge and utilization of desktop applications to include Word and Excel are essential.</li><li>
General hospital A/R accounts knowledge is required.</li><li>
Performs other special projects as required when assigned.</li></ul>
Collections &ndash; Insurance
<ul><li>Maintains active knowledge of all collection requirements by payors.</li><li>
Collects balance owing from third-party payers in accordance with State and Federal laws governing collections practices. Ensures that collection efforts are thorough with the overall objective being to collect outstanding balances in an ethical manner.</li><li>
Ensures quality standards are met and proper documentation regarding patient accounting records.</li><li>
Contact other departments to obtain necessary information for appeals, pending information, and any other issues that impact and/or delay claim processing.</li></ul>
Collections &ndash; Self Pay
<ul><li>Ensures that self-pay accounts are handled in a customer service-oriented manner that accomplishes the goal of collecting monies due to clients, while at the same time preserving the positive image of TLRA that exists in the community.</li><li>
Responsible for assisting patients in identifying eligible means of financial assistance or if non apply working with the patient to make acceptable payment arrangements.</li><li>
Must be an effective team member with good communication skills. Must participate in team meetings, communicate work-related ideas and concerns proactively, and assist in finding appropriate resolutions.</li></ul>
Physician Billing/Collections
<ul><li>Ensure proper reimbursement for all services and to ensure all appeals are filed timely.</li><li>
Review accounts and determine appropriate follow-up activities utilizing Six Sigma Practices.</li><li>
Identify under and overpayments and take appropriate actions to resolve accounts.</li><li>
Validate commercial insurance claims to ensure the claims are paid according to the contract.</li><li>
Direct knowledge using Meditech and CollectLogix software.</li><li>
Monitor and communicate errors generated by other groups and evaluate for trends.</li></ul>
Job Requirements: 
Education/Skills
<ul><li>High School diploma or equivalent years of experience required.
</li></ul>Experience
<ul><li>3-5 years of experience preferred.
</li><li>experience in a Customer Service call center environment with a focus on healthcare billing/collections or collection agency environment required.
</li><li>College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
</li></ul>Licenses, Registrations, or Certifications
<ul><li>None required.</li></ul> 
Work Schedule: 
MULTIPLE SHIFTS AVAILABLE
Work Type: 
Full Time</div>

Patient Account Specialist Senior-TLRA Insurance

<div>Description 
Summary:
Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction is essential. Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and BD inventory.
Responsibilities: 
<ul><li>Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.</li><li>
Provides effective collection services, ensuring the successful recovery of accounts in accordance with client and state guidelines as well as TLRA&rsquo;s business objectives.</li><li>
Documents and updates patient account information in TLRA&rsquo;s collection software system timely and accurate to include appropriate account status.</li><li>
Handles inbound patient and/or carrier calls promptly and professionally, providing assistance and resolution to account inquiries, issues, and requests.</li><li>
Uses collection tools effectively to ensure quality recovery services and meet or exceed established goals and work standards.</li><li>
Performs research and analysis of account issues and strives to resolve problems timely and accurately.</li><li>
Ensure daily productivity standards are met.</li><li>
Promotes positive patient relations by communicating in a manner that demonstrates respect for the human dignity of patients and/or their families.</li><li>
Must have solid knowledge and utilization of desktop applications to include Word and Excel are essential.</li><li>
General hospital A/R accounts knowledge is required.</li><li>
Performs other special projects as required when assigned.</li></ul>
Collections &ndash; Insurance
<ul><li>Maintains active knowledge of all collection requirements by payors.</li><li>
Collects balance owing from third-party payers in accordance with State and Federal laws governing collections practices. Ensures that collection efforts are thorough with the overall objective being to collect outstanding balances in an ethical manner.</li><li>
Ensures quality standards are met and proper documentation regarding patient accounting records.</li><li>
Contact other departments to obtain necessary information for appeals, pending information, and any other issues that impact and/or delay claim processing.</li></ul>
Collections &ndash; Self Pay
<ul><li>Ensures that self-pay accounts are handled in a customer service-oriented manner that accomplishes the goal of collecting monies due to clients, while at the same time preserving the positive image of TLRA that exists in the community.</li><li>
Responsible for assisting patients in identifying eligible means of financial assistance or if non apply working with the patient to make acceptable payment arrangements.</li><li>
Must be an effective team member with good communication skills. Must participate in team meetings, communicate work-related ideas and concerns proactively, and assist in finding appropriate resolutions.</li></ul>
Physician Billing/Collections
<ul><li>Ensure proper reimbursement for all services and to ensure all appeals are filed timely.</li><li>
Review accounts and determine appropriate follow-up activities utilizing Six Sigma Practices.</li><li>
Identify under and overpayments and take appropriate actions to resolve accounts.</li><li>
Validate commercial insurance claims to ensure the claims are paid according to the contract.</li><li>
Direct knowledge using Meditech and CollectLogix software.</li><li>
Monitor and communicate errors generated by other groups and evaluate for trends.</li></ul>
Job Requirements: 
Education/Skills
<ul><li>High School diploma or equivalent years of experience required.
</li></ul>Experience
<ul><li>3-5 years of experience preferred.
</li><li>experience in a Customer Service call center environment with a focus on healthcare billing/collections or collection agency environment required.
</li><li>College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
</li></ul>Licenses, Registrations, or Certifications
<ul><li>None required.</li></ul>
Work Type: 
Full Time
EEO is the law - click below for more information:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at (844) 257-6925.</div>

Patient Account Specialist Senior - TLRA Insurance

University of Texas Medical Branch

<div>EDUCATION &amp; EXPERIENCE:
Minimum Qualifications:<ul><li>
Two years of financial experience or one year of patient accounts experience.
</li></ul>JOB SUMMARY:
The Patient Account Specialist will be responsible for billing all third-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:<ul><li>
Demonstrates a level of competence and understanding of all state and federal laws, rules, and regulations regarding payer billing guidelines</li><li>
Demonstrates a basic understanding of CPT, ICD-9, HCPCS, modifier coding as well as POS requirements</li><li>
Billing payers and/or clients for hospital and/or Professional Patient Accounts</li><li>
Resolves Payer rejections from billing system daily to bill submit hospital and/or physicians claims</li><li>
Performs online corrections to edited claims according to procedures</li><li>
Performs detailed follow-up activities on assigned accounts according to procedures</li><li>
Responds to daily correspondence according to procedures</li><li>
Identifies denials and underpayments for appeal</li><li>
Reviews, researches, and processes denied claims</li><li>
Appeal claims as appropriate according to policies and procedures</li><li>
Updates account information and documents as appropriate within Epic Resolute</li><li>
Processes account adjustments according to policies/procedures</li><li>
Issues payer and/or patient refunds according to policies/procedures</li><li>
Validates accuracy of payments and/or adjustments on accounts</li><li>
Resolves outstanding accounts at required accuracy and productivity requirements</li><li>
Maintains comprehensive knowledge of the work unit assigned</li><li>
Assists in the development of department policies and procedures</li><li>
Adheres to established policies and procedures</li><li>
Adheres to internal controls and reporting structure</li><li>
Maintains open and professional communication with customers, colleagues, and vendors</li><li>
Performs well in a team environment</li></ul>
Marginal or Periodic Functions:<ul><li>
Successfully completes competency-based training and testing</li><li>
Prioritizes and completes all work in an accurate, effective, and efficient manner</li><li>
Participates in team meetings/activities and supports the philosophy and goals of the team and department</li><li>
Assists in the training and mentoring of new employees</li><li>
Reads all announcements and relevant communications relating to job duties</li><li>
Performs related duties as required.</li></ul>
WORKING ENVIRONMENT/EQUIPMENT:<ul><li>
Standard hospital, clinical, laboratory and/or office environments.</li><li>
Standard office equipment.</li></ul>
SALARY RANGE:
Actual salary commensurate with experience.
WORK SCHEDULE:
On-site, Monday through Friday, 8 AM - 5 PM. 
Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.</div>

Patient Account Specialist - Revenue Cycle HB Billing & Denials

Presbyterian Healthcare Services

<div>Location Address:
9521 San Mateo NE Albuquerque, NM 87113-2237

Compensation Pay Range:
Minimum Offer $15.60 Maximum Offer $22.12 Now Hiring: Patient Access Account Specialist I-ABQ
Summary:
Under the direction of the Patient Access Supervisor, the Patient Access Account Specialist I provides basic functions to financial clear patient accounts for government and commercial accounts prior to the date of service. Performs basic financial clearance functions, including insurance verification, authorization, collection and documentation of patient demographics, benefit analysis, and pre-service collections. The Patient Access Account Specialist I will ensure follow up on authorizations for scheduled and Urgent/Emergent procedures and admissions until date of service or discharge for admissions. The Patient Access Account Specialist I must possess a basic knowledge of Medicare (CMS) guidelines, as well as other Compliance Regulatory guidelines applicable to Patient Access to include HIPAA, EMTALA, and CMS guidelines of MSPQ. The Patient Access Account Specialist (PAAS I) monitors work queues for financial clearance and missing authorizations ensuring a payment source is identified and secured and there is a clean claim for billing. The Patient Access Account Specialist I acts as resource to all employees within Patient Access. The Patient Access Account Specialist I is responsible for providing the highest level of customer service to patients, ancillary departments and payers when financially clearing accounts. The PAAS I will work with ancillary departments to ensure the procedures scheduled and authorized meet payer requirements. The Patient Access Account Specialist I provides coverage to other areas and hospitals as needed to minimize overtime and guarantee the patients receive services as needed without registration delays. Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Days (United States of America)

Responsibilities:
Customer Service and Caring Practices: *Achieve exceptional patient experience for patients and patient families by using CARES, AIDET and EPE tools. *Addresses and attempts to appropriately resolve complaints in the moment by using key words at key times and de-escalation processes. *Ability to manage conflict and appropriately request the help of a supervisor when needed. *Implement PROMISE and CARES behaviors in every encounter. *Educates patients for whom they speak regarding insurance benefits and liabilities. *Ensures accounts are financially cleared prior to date of service to alleviate patient concerns over hospital financial matters Encounter Components: *Performs the patient registration process. Manage the accurate collection of patient data which includes but is not limited to; *Obtain/confirm and enter demographic and other financial and clinical information necessary for final clearance of scheduled accounts. *Review Urgent/Emergent admission accounts for notification, financial clearance and authorization pre-discharge. *Obtain missing insurance information, to include policy number, group number, date of birth, and insurance phone number if not already identified in account. *Verify insurance for eligibility and benefits using online electronic verification system or by contacting payer directly. *Review and process work queues related to Patient Access pre-visit or urgent/emergent admissions, per department guidelines. *Review of accounts falling within the work queues to ensure the insurance information contains accurate policy ID#s, Group Name and Numbers, Subscriber information, Authorization numbers, as well as correct payer and Coordination of benefits prior to date of service. *Accurately document actions taken in the system of record to drive effective follow-up and ensure an accurate audit trail. *Maintain ongoing knowledge of authorization requirements and payer guidelines. Maintain a proficient knowledge of Medicare (CMS) guidelines as it relates to admissions and outpatient services. Ensuring compliance with admissions forms, benefit entitlement verification, and billing requirements *Ensure accurate completion of MSPQ prior to date of service. *Daily focus on attaining productivity standards; recommend new approaches for enhancing performance and productivity when appropriate. *Monitor and track Data Quality program to ensure errors are corrected prior to final bill and correct accounts as necessary. *Maintain appropriate records, files, and timely and accurate documentation in the system of record. *Work with ancillary departments to ensure coding, diagnosis and facility are authorization are in alignment. *Work with payers to ensure authorization is in place; initiating the auth when appropriate. *Coordinate efforts with Financial Advocates to secure payer source current and future visits. *Monitor work queues to identify late add-on accounts and complete financial clearance procedures prior to services to avoid unauthorized procedures from being performed. *Work with physician offices to resolve discrepancies in authorizations and scheduled procedures. Financial Accountabilities: *Collects identified patient financial obligation amounts including residual balance if applicable. Collect liability from patient prior to visit or make arrangements for payment at time of service. *Ensure a payer source has been identified prior to services being rendered. *Ensure authorization for correct procedure (CPT), facility, and date of service is obtained. Patient Relations *Contact patients pre-visit to complete any information missing from the account to ensure accuracy prior to visit. *Transparency with patients through communication of patient liabilities and authorization issue in a timely manner, allowing patients ability to make informed decisions. *Educate patients and answer questions from patients on benefits, liabilities and financial options. *Provide patient with way-finding for appointment at time of pre-registration. *Perform AIDET when speaking to patient to alleviate anxiety and confusion. Quality Improvement: *Perform assigned patient care responsibilities, which may include but not limited to: *Cooperate fully in all risk management activities and investigations. *Report promptly any suspected or potential violations to laws, regulations, procedures, policies, and practices, and cooperate in related investigation. *Conduct all transactions in compliance with all company policies, procedures, standards, and practices. *Demonstrate knowledge of all applicable compliance and legal requirements of the job based on the scope of practice of the position. C.A.R.E.S Behaviors: *Demonstrates CARES behaviors of Collaborate, be Accountable, Respect, Engage and Serve to all whom you encounter. *Other duties as assigned
Qualifications:
*High school diploma, continued education preferred *External and Internal Non-Patient Access Candidates: Pass Patient Academy with passing score of 85% or higher *Previous completion and passing of Patient Access Advocate II and III Advancement test. *A minimum of 2 years of work experiences in healthcare setting within Patient Access and/or billing plus strong customer service background. *Strong knowledge and understanding of insurance and financial processing of accounts. *Proficient in EPIC ADT system *Specialty Certifications: CHAA, CHAM or other industry equivalent certification preferred *Pass annual competency exam for all areas of responsibility. *Requires general knowledge of the customer encounter process which may include registration, contract requirements, and coordination of benefits. *Knowledge in Microsoft Office Products. *Demonstrated strong keyboarding skills, ensuring efficient data entry and documentation. *Pass EPIC proficiency test required with a 85% score at completion of the Epic Training class. UPDATED 7/29/25
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits. 
Wellness 
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more. 
Why work at Presbyterian? 
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. 
About Presbyterian Healthcare Services 
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.<h1 class="jobSectionHeader">
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services</h1></div>

Patient Access Account Specialist I-ABQ

Risas Dental and Braces

<div>Employment Status: Full-time 
 
✓ Dental Insurance ✓ Health Insurance ✓ Life Insurance
✓ 12hr ✓ Rotating
At Risas Dental and Braces, our focus is providing quality and affordable dental care and braces for families everywhere. Our goal is to think and speak a language that patients understand. For this reason, our Company Statement is We Speak Patient&trade;. The result is happier, healthier Patients, and better opportunities for our doctors and team members. 


We are seeking a friendly and professional bilingual Account Specialist to join our Risas family. The Account Specialist must have excellent customer service skills, a dynamic personality, be highly motivated, and detail-oriented. The Account Specialist works with patients to discuss payment options, insurance benefits and eligibility, financial account accuracy, and account balance resolution. We value good communication skills, reliability, a positive attitude, and organizational talents. 

Responsibilities 
<ul>
<li>Present and explain financial arrangements, monthly billing and collecting with patients</li>
<li>Post payments, charge new accounts, and close out for the deposit</li>
<li>Verify insurance benefits prior to all new patient exams</li>
</ul><ul><li>Educate and encourage patient's commitment to long-term treatment</li>
<li>Identify, address, and resolve any patient concerns</li>
<li>Validate and/or obtain authorization for payment from patients</li>
<li>Follow up with insurance companies regarding eligibility and payments</li>
<li>Bill insurance within 24 hours of the start of treatment</li>
</ul><ul><li>Close out the month and complete month-end reports</li>
<li>Additional duties and responsibilities as assigned</li></ul> 
 
Qualifications 
<ul>
<li>Bilingual in English and Spanish</li>
</ul><ul><li>High School Diploma or GED equivalent</li>
<li>Customer service experience over the phone a plus</li>
<li>Knowledgeable of dental and medical terminology preferred</li>
<li>Exceptional written and verbal communication abilities</li>
<li>Excellent organizational skills and ability to multitask</li>
</ul><ul><li>Ability to utilize de-escalation skills being an empathetic, active listener, who has strong follow through skills when speaking with patients</li>
<li>Ability to think creatively, problem solve, and work independently</li>
<li>Must have a growth mindset and the ability to adapt to change</li>
<li>Ability to work within a team environment and lend support, as a team player, to team members as needed</li></ul> 


Benefits

Risas Dental and Braces offers a comprehensive benefits package including
<ul>
<li>12-hour shifts, 3 days a week</li>
<li>Medical and vision benefits</li>
<li>Free dental services</li>
</ul><ul><li>401(k) with employer match</li>
<li>Tuition reimbursement opportunities</li>
<li>And many other ancillary benefits</li></ul> 


The working environment is fun, fast paced, challenging, and rewarding with opportunities for professional development and career advancement. Join us in this work. Begin a career that is full of meaning and value.</div>

Patient Accounts Specialist

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