patient accounts specialist

HARBIN CLINIC

<div></div><div><div><div><div><div><div><div><div><p>NC, United States<br>
Job ID: R166026
<br>
Shift: Various
<br>
Job Type: Regular
</p></div><div><div><div><div>Share: mail</div></div></div></div><div></div><div><br>
</div></div><p></p><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p><b>Department:</b></p></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div>
13281 Enterprise Revenue Cycle - Rev Cycle Strategic Support Team: Southeast<p></p><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p><b>
Status:</b>
</p></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div>Full time<p></p><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p><b>
Benefits Eligible:</b></p></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div>
Yes<p></p><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p><b>
Hou</b><b>rs Per Week:</b></p></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div>
40<p></p><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p><b>
Schedule Details/Additional Information:</b></p></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div>
Variable<p></p><p><b>
Pay Range</b></p>
$21.85 - $32.80<p></p><p><b>
Job Summary</b></p>
Patient Accounts Specialist (PAS) works under the immediate supervision of supervisors/managers in Patient Financial Services (PFS). PAS positions perform complex tasks requiring critical thinking skills and experience-based (specialist) knowledge in PFS. Reviews difficult work queues, large dollar accounts, aged accounts and any special projects assigned by leadership. Creates reports/spreadsheets for identification of problem areas and utilizes critical thinking skills to determine appropriate actions to resolve problem. Must demonstrate thorough knowledge and understanding of patient billing, billing transmission, government regulatory/ compliance requirements, and electronic billing systems.<br>
<p><br>
<br>
<b>Essential Functions</b></p><br>
<ul><li>Prepares reports of denials, credit balances, payer opportunities.</li>
<li>Analyzes rejection reports and errors made by system and teammates. Requests system changes, reports error rates by teammate and collaborates with training to ensure improvement is achieved and sustained.</li>
<li>Prepares Medicare/Medicaid quarterly credit balance reports. Approve refunds as defined in departmental threshold guidelines.</li>
<li>Assists Supervisor/ Manager with quality checks for all payers and departments.</li>
<li>Performs quality assurance tasks as needed to validate workflow builds, claim edit actions, automatic actions in Epic, process improvements, etc.</li>
<li>Analyzes denial reasons provided by payers. Collaborates with management to identify, trend and address root causes of denials.</li>
<li>Researches and analyzes payer trends and works on special projects involving aged, high dollar or complex account issues.</li>
<li>Trains new teammates as needed.
</li></ul><p></p><b>Physical Requirements</b><br>
<p></p>Requires sitting for long periods of time. Requires bending and may need to lift-up to 10 pounds occasionally.<br>
<p><br>
<br>
<b>Education, Experience and Certifications</b></p><br>
High school diploma or GED required. Two-years' experience in related financial services or healthcare business office required. College (bachelor's or associate) degree preferred. Requires the ability to communicate effectively in verbal and written formats. Proficiency in Word, Excel and Outlook preferred. Prior healthcare computer system and specifically Epic billing experience preferred.<p></p><p><b>
Our </b><b>Commitment to You:</b></p><p></p><p>
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more &ndash; so you can live fully at and away from work, including:</p><p></p><p><b>
Compensation</b></p><ul><li>
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training</li><li>
Premium pay such as shift, on call, and more based on a teammate's job</li><li>
Incentive pay for select positions</li><li>
Opportunity for annual increases based on performance</li></ul><p></p><p><b>
Benefits and more</b></p><ul><li>
Paid Time Off programs</li><li>
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability</li><li>
Flexible Spending Accounts for eligible health care and dependent care expenses</li><li>
Family benefits such as adoption assistance and paid parental leave</li><li>
Defined contribution retirement plans with employer match and other financial wellness programs</li><li>
Educational Assistance Program</li></ul><p></p><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p><b>
About Advocate Health</b></p><p></p><p>
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation&rsquo;s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.</p></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div><p>
</p>Patient Accounts Specialist</div></div></div></div></div></div></div><div></div>

Patient Accounts Specialist

Risas Dental and Braces

<div><p>Employment Status: Full-time<br>
<br>
</p><p>✓ Dental Insurance ✓ Health Insurance ✓ Life Insurance
</p><p>✓ 12hr ✓ Rotating
</p><p>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.</p><br>
<p></p>
<p>
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.</p><p><br>
<b>
Responsibilities</b></p><br>
<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><br>
<p><br>
<b>Qualifications</b></p><br>
<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><br>
<p></p>
<p><b>
Benefits</b></p>
<p>
Risas Dental and Braces offers a comprehensive benefits package including</p>
<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><br>
<p></p>
<p>
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.</p></div>

Bates County Memorial Hospital

<div><p>This opening is for a 40 hour per week day shift position.</p><p>
The Patient Account Specialist is responsible for the prompt billing and follow up of Insurance Claims in order to expedite payments; monitors and prevents accounts from aging past timely filing; resolves Credit Balances while meeting Federal and State regulations. Identifies trends and communicates those to appropriate staff members for resolution. Provides customer service to patients regarding billing.</p>
<p><b>
Experience and Education:
</b></p><ul><li>Knowledge of the Microsoft office suite</li><li>
Knowledge of standard office equipment (copier, fax machine)</li><li>
Ability to type and use a 10 key</li><li>
Knowledge of Medical and insurance terminology, such as cpt and diagnosis codes.</li></ul>
<p><b>
Minimum:</b></p>
<ul><li>
1-2 years of experience in medical Billing/Follow up for a facility, medical clinic or doctor&rsquo;s office.</li></ul><p><b>
Knowledge/Skills/Abilities Required</b></p>
<ul><li>
Personal technology device to download software application to enable access to hospital email by multi-factor authentication.</li><li>
Displays good organizational skills and utilizes time wisely.</li><li>
Maintains a neat and orderly work environment.
</li><li>Completes assigned tasks in a timely manner and seeks additional work upon completion of assignments.</li><li>
Displays attention to detail and accuracy of tasks</li><li>
Demonstrates good communication skills and empathy</li><li>
Willingly shares information and resources with co-workers.
</li><li>Takes the time to explain and exchange information with customers.</li><li>
Maintains composure under stress and continues to work effectively.</li><li>
Discusses personal, patient, and staff-related issues in a confidential manner and in the appropriate location and follows Hospital policy concerning Confidentiality.</li><li>
PC skills &ndash; demonstrates proficiency in Microsoft Office applications and others as required</li><li>
Treats customers in an ethical manner, respects the dignity and individuality of customers. Demonstrates commitment to customers by putting their well-being before personal, financial, or procedural concerns.</li></ul></div>

Western CBO

<p><b>Universal Health Services (UHS) - Western Region Consolidated Business Office (WCBO)</b></p><p>The Western Region Consolidated Business Office delivers comprehensive insurance revenue services to our affiliated UHS facilities, encompassing billing, collections, cash posting, pre-access management, variance analysis, and customer service. Our dedication to associate satisfaction and growth is recognized by industry leaders, exemplifying our commitment to fostering a positive and inclusive workplace culture. Our associates can count on competitive salaries, top-tier medical, dental, and retirement benefits, career training, and support for continued professional development.</p><p><b>Job Description: Patient Accounts Specialist Monday-Friday 5:00AM-1:30PM</b></p><p>The Patient Accounts Specialist manages Medicare billing and collections, including verifying medical insurance, processing reimbursements, correcting cash posting errors, and handling denials and appeals. Additional duties include, validating codes and charges are correct, preparing and submitting claims according to Medicare payer guidelines, and ensuring accurate and timely claim submissions.</p><p><b>Experience:</b><br/>2+ years medical insurance billing and collections experience.</p><p><b>Education:</b><br/>High School or equivalent.</p><p><b>Requirements:</b></p><ul><li>Demonstrates knowledge of medical insurance billing and collections.</li><li>Experience with denials and appeals.</li><li>Excel and data entry systems experience.</li></ul><p><b>This opportunity offers the following:</b></p><ul><li>Challenging and rewarding work environment</li><li>Growth and Development Opportunities within UHS and its Subsidiaries</li><li>Competitive Compensation</li><li>Excellent Medical, Dental, Vision and Prescription Drug Plan</li><li>401k plan with company match</li></ul><p><b>Universal Health Services:</b></p><p>One of the nation&rsquo;s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World&rsquo;s Most Admired Companies by Fortune; and listed in Forbes ranking of America&rsquo;s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network, and various related services located all over the U.S. States, Washington, D.C., Puerto Rico, and the United Kingdom. www.uhs.com.</p><p><b>EEO Statement:</b></p><p>All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state, or local laws.</p><p>We believe that diversity and inclusion among our teammates is critical to our success.</p><p><b>Notice:</b></p><p>At UHS and all our subsidiaries, our Human Resources departments and recruiter are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card, or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.</p><p>Pay: $18.00 - $23.31 per hour</p><p>Benefits:</p><ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul><p>Work Location: In person</p>

PATIENT ACCOUNTS SPECIALIST - MEDICARE

Lake County, IL

<div><div><div><h2 class="jobSectionHeader"><b>General Description</b></h2></div>
<div><p>The Patient Accounts Billing Specialist is a valuable member of our Finance team who under general supervision performs work of considerable difficulty in assisting with the administration of the Health Department&rsquo;s central billing office management program. The position has the responsibility for reviewing, researching, analyzing, and performing collections of outstanding patient balances. Ensures accurate records are kept for all sliding fee activity to ensure the agency complies with all appropriate regulations as required. Ensures patients with a spenddown amount within a government program have their services billed appropriately. Performs customer service and payment collection as assigned. Provides various patient management reports as needed. Use of multiple medical billing and financial programs are essential to this position. Strong problem-solving ability, high level analytical ability and critical thinking skills are needed to perform this role successfully.<br>
<br>
<b>Scheduled Hours: 37.5 hours per week</b></p></div>
<div><h2 class="jobSectionHeader"><b>Essential Functions</b></h2></div>
<p></p><div><ul><li>Responsible for processing patient refunds.</li><li>
Responsible for processing patient bad debt.</li><li>
Responsible for collection of private pay balances.</li><li>
Assist patients with obtaining access to a LCHD navigator, setup of payment plans or Financial Hardship using established protocols.</li><li>
Audit, analyze and correct patient sliding fee applications.</li><li>
Re-bill and adjust patient accounts as necessary using the NextGen system.</li><li>
Assist in deposit resolution between Treasurer&rsquo;s, clinics and Finance.</li><li>
Interpret and explain eligibility results.</li><li>
Create patient management reports using the NextGen system.</li><li>
Analyze and resolve accounts receivable aging issues.</li><li>
Use Microsoft Excel to create spreadsheets to assist in the analysis of patient data.</li><li>
Trace the transactions through NextGen from charge entry through claim creation as part of problem resolution.</li><li>
Resolve all patient inquiries from internal and external customers.</li><li>
Keeps thorough records of all activity including reporting and tracking of billing adjustments or corrections.</li><li>
Develops and maintains a basic knowledge of services available at the Lake County Health Department and Community Health Centers (LCHD/CHC).</li><li>
Participates in quality improvement activities to assess, monitor and improve program services.</li><li>
Participates in staff meetings, in service trainings, and seminars to facilitate professional growth and maintain licensure if required.</li><li>
Involvement in quality improvement activities on an ongoing basis.</li><li>
Assists with other projects and duties as assigned.</li></ul></div><p></p>
<div><h2 class="jobSectionHeader"><b>Knowledge Skills Abilities and Education Required</b></h2></div>
<p></p><div><ul><li>Completion of a high school diploma or G.E.D. certificate. Associate&rsquo;s Degree or certification in health information technology or accounting is preferred.</li><li>
two years experience using an Electronic Practice Management system.</li><li>
Two years of collections experience in a provider setting.</li><li>
Advanced Proficiency in Excel and utilizing ten-key data entry is required.</li><li>
Experience with different reporting software.</li><li>
Bilingual is preferred.</li></ul></div><p></p>
<div><h2 class="jobSectionHeader"><b>Supplemental Information</b></h2></div>
<p></p><div><p>As the largest human service provider in Lake County, we believe that services must be available without barriers. No residents are turned away due to the inability to pay. We believe in providing services in an environment of mutual respect, free of discrimination or bias. Whether assuring accessible and effective care, impacting policy, or assessing and monitoring risks, the Lake County Health Department and Community Health Center has been an essential part of the public health system in Lake County for 60 years. <b>We are looking for passionate, qualified team members who can help make a difference in our agency and, most importantly, in our community.</b></p><p>
Additional information about the Lake County Health Department, our culture, and why you should join our team can be found at https://lakecountyil.attract.neogov.com/health-department.</p><p><b>
At this time, you must live in Illinois or Wisconsin to be eligible to work at Lake County Health Department. </b>You can find our <b>salary grades </b>at https://www.lakecountyil.gov/4515/Salary-Grades. For unionized positions, a list of our <b>collective bargaining agreements </b>can be found here: https://www.lakecountyil.gov/2686/Collective-Bargaining-Agreements.</p><p>
Any offer of employment is conditioned on the successful completion of a background screening, drug and alcohol testing and may include a pre-employment medical exam.</p><p><i>
The Lake County Health Department and Community Health Center is an Equal Opportunity Employer. We evaluate qualified applicants without regard to race, color, religion, sexual orientation, gender identity or gender expression, national origin, disability, veteran status, and other protected characteristics.</i></p></div></div></div><p></p>

Patient Accounts Billing Specialist

Presbyterian Healthcare Services

<div><p><b>Location Address:</b></p>
9521 San Mateo NE Albuquerque, NM 87113-2237
<p></p><p><b>
Compensation Pay Range:</b></p>
Minimum Offer $15.60 Maximum Offer $22.12 Now Hiring: Patient Access Account Specialist I-ABQ<p></p><p><b>
Summary:</b></p><p></p>
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)
<p></p><p><b>
Responsibilities:</b></p><p></p>
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<p></p><p><b>
Qualifications:</b></p><p></p>
*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<p></p><p>
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.</p><p><b><br>
Wellness</b><br>
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.</p><p><b><br>
Why work at Presbyterian?</b><br>
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.</p><p><b><br>
About Presbyterian Healthcare Services</b><br>
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.</p><p></p><p>
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.</p><p></p><p><i>
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.</i></p><p></p><h1 class="jobSectionHeader"><b>
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services</b></h1></div><p></p>

Patient Access Account Specialist I-ABQ

North East Medical Services

<div><p><b>SUMMARY OF POSITION:</b><br>
</p><p>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.</p><p>
</p><h1 class="jobSectionHeader"><b>ESSENTIAL JOB FUNCTIONS:</b></h1><ul><li>
Reviews, edits, processes, and submits <b>electronic and hardcopy claims</b> to various payers (Medicare, Medicaid, Managed Care, and Private Insurance) for <b>FQHC (Federally Qualified Health Centers)</b> and <b>FFS (Fee-For-Service)</b> reimbursement, ensuring accuracy of payment entries and completeness of charge capture information.</li><li>
Maintains up-to-date knowledge of <b>medical billing requirements</b> 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 <b>aging reports</b> to minimize delays in reimbursement.</li><li>
Responds to <b>payer requests and remittance advices</b> 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 <b>Patient Account Specialist II</b>, 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 <b>NEMS physicians&rsquo; hospital visits</b>.</li><li>
Provides <b>training and support</b> 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 <b>billing records retention</b>.</li><li>
Acts as a <b>liaison</b> 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"><b>
</b></h1><p></p><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<br>
<li>
</li></ul><p><b>LANGUAGE:</b></p><ul><li>
Proficient in written and spoken English and Chinese (Cantonese and/or Mandarin)</li>
Fluent in other languages is an asset<br>
<li>
</li></ul><p><b>STATUS:</b></p><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.<br>
<li>
</li></ul><p>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.</p><p>
NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).</p></div>

PATIENT ACCOUNT SPECIALIST I

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