Financial Account Specialist

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Position Summary The Financial Account Specialist is responsible for all billing and follow-up processes for selected inpatient and outpatient claims, daily payment reconciliation, processing of refund applications and must possess the ability to use multiple systems.

Core Responsibilities

• Processes all billing both accurately and timely. Billing includes:
• Hard copy submission
• Electronic-Med-assets
• Secondary billing
• Carve out items
• Late charges
• Adjustments
• Research and processes corrections for claims denying or suspending due to incorrect, incomplete, or missing information.(i.e. RTP file, Functional Acknowledgement (FA), remittances)
• Identifies contractual allowances that are not generated or generated incorrectly and allowance the account to the correct rate.
• Identifies and informs Team Leader of system issues (i.e. incorrect allowances, reports, bill form issues and revenue, CPT, ICD-10 Coding)
• Identifies and informs Team Leader of input issues and provides examples. (i.e. policy ID#'s incorrect, insurance address or phone # not documented, incorrect primary verified.)
• Understands UB04 form
• Processes remittances/EOB's both timely and accurately. Identifies payer or system issues and gives examples to Team Leader.
• Follows up on all aged accounts receivable. Follows the priority order established by the Team Leader.
• Rebills claims that are not in receipt of payer. Informs Team Leader of any non-receipt trends.
• Processes late charges when appropriate in accordance with the departmental procedures.
• Processes correspondence both timely and accurately. Informs Team Leader of payer trends.
• Process credit balances in priority order as established by Management or departmental policy.
• Informs Team Leader of backlogs in a timely manner.
• Follows up with Commercial / Managed Care payers

Minimum Requirements

• High School Degree or GED; or equivalent experience
• 2-4 years related work experience
• Intermediate computer skills
• Excellent communication, organizational, and interpersonal skills
• Detail oriented

Preferred Requirements:

• Certified Patient Account Technician (CPAT)
• Certified Professional Coder (CPC)

Additional information

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required.
• This should not be construed as an exhaustive statement of duties, responsibilities or requirements, but a general description of the job. Nothing contained herein restricts the company's rights to assign or reassign duties and responsibilities to this job at any time.
• Shore Medical Center is an Equal Opportunity Employer. All applicants will receive consideration for employment without regard to sex, affectional or sexual orientation, gender, gender identity, orientation or expression; marital status, domestic partnership status, civil union status, pregnancy, race, creed, ancestry, color, ethnicity, national origin, age, disability, religion, genetic information, or veteran status or any other basis prohibited by law.

Location: Shore Medical Center · Patient Billing Schedule: Days, 7:00am-3:30pm