Patient Accounts Services

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A/R Hospital Specialist (FC)

at Patient Accounts Services

Posted: 4/3/2018
Job Reference #: 209
Keywords: patient

Job Description

Fort Washington, Pennsylvania

Job Code:

# of Openings:

Job summary

The A/R Specialist is responsible for daily adjudication of claims; processed within the scope of the Client(s) contracted services and parameters of available systems

Summary of essential job functions

  • Review and process outstanding Client accounts receivable, as assigned, to facilitate subsequent payment and claims adjudication on a timely basis; working an average of 40 to 50 accounts daily
  • Perform insurance verification as well as the preparation and submission of electronic and paper claims for various carriers, including, but not limited to governmental and managed care payers
  • Review payments, from both remittances and EOB’s, for accuracy.  Process appropriate adjustments and/or payments when necessary 
  • Investigate and reprocess denials and partial payments
  • Prepare patient files verifying completeness and accuracy of information necessary for billing and payment, including, but not limited to:
    • Patient/Guarantor data
    • Insurance data
    • Authorizations (when necessary)
    • Financial data to include charges, payments, and adjustments
  • Follow all HIPAA related procedures ensuring the maintenance of patients’ PHI (Protected Health Information)
  • Other related tasks as assigned

Minimum requirements

  • Proficient in Microsoft Word and Excel and Outlook
  • Knowledge of CPT-4/HCPC, ICD-9-CM, ICD-10CM, DRGs and Revenue Codes
  • Knowledge of UB-04, and 1500 bill forms
  • Minimum of 3 years experience in a Hospital patient accounting or medical insurance environment preferred
  • Familiar with third party billing practices, including but not limited to managed care payers and governmental payers

Abilities required

Some travel to Client sites

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