Account Resolution Specialist Patient Financial Services-Burle Bldng (40 hours/week, 1st shift)
Lancaster General Hospital
2044 PFS Account Resolution
HB Account Resolution
Full Time: 40 hrs per week. Mon-Fri 8 am to 4:30 pm. No weekends or major holidays.
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POSITION SUMMARY: Maximizes cash collections and resolution of aged accounts through informed, consistent follow up activities. Responsible for the timely billing and follow-up of assigned accounts and for ensuring all accounts are paid correctly according to insurance contract terms. Consistently identifies account deficiencies that require subsequent follow-up and ensures all deficiencies are resolved. Escalates issues to supervisor and tracks data for trending and feedback purposes. Works within a structured team setting to ensure team goals and well as individual goals are met in an appropriate manner.
ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:
- Analyzes and researches denials and follows-up with the appropriate payor, practice, and/or patient to resolve denial. Provides missing or additional information if necessary, to expedite the resolution of the denied claim.
- Performs all appeals and denial recovery procedures needed to appropriately and accurately resolve denied claims.
- Processes required adjustments to accounts, including charges credits, payment transfers, policy adjustments, etc. in a timely and accurate manner.
- Maintains a thorough knowledge and understanding of all assigned payor contracts and requirements.
- Performs research to ensure current policies, applicable coding and insurance guidelines, regulations and laws are being followed.
- Evaluates processes and procedures and makes practical suggestions/recommendations for improvement or compliance.
- Prepares accurate and timely reports of trends and problems as they are identified. Communicates such trends to management in a timely manner.
- Consistently identifies account deficiencies that require follow up and ensures that appropriate actions have occurred.
- Completes work accurately and timely with appropriate documentation.
- Ensures that all activities related to denials management functions meet department requirements, maximize revenue collection, and achieve leading practice levels of performance.
- Consistently meets productivity and quality standards established by management, recommending new approaches for enhancing performance and productivity when appropriate.
- Keeps Supervisor/Manager informed of any problems or issues.
Posted on 08/14/2019
- High School diploma or equivalent.
- Strong written and verbal communication skills.
- Microsoft Office experience.
- Strong organization skills.
- Ability to apply strong analytical qualities.
- Associate’s degree preferred
- One (1) to two (2) years of experience in hospital or physician billing/insurance follow up preferred.