What are the responsibilities and job description for the Patient Account Specialist - Business Services position at Christie Management Company, Inc?
Christie Clinic's department of Business Services is seeking a full-time Patient Account Specialist from Monday - Friday 8:00am-5:00pm at the University Clinic.
This role is responsible for researching medical claim denials, speaking with medical insurance companies and resolving medical claims and medical insurance issues. Performs analytical duties to ensure timely processing of medical claims to maximize reimbursement. Participates in cross-training and provides coverage for co-workers during the extended absence of a co-worker.
JOB DUTIES: (This list may not include all of the duties assigned.)
- Verify insurance eligibility for patients by accessing on-line information available by through various carriers’ websites or via telephone for those that require that method.
- Process Charge Reviews via email and through the Guarantor Workqueues daily to verify information such as CPT & Diagnosis codes, dates of service and level of service, to request copies of documentation (email only) or research insurance issues.
- Post adjustments and remark codes in Epic and research insurance payments and process necessary corrections.
- Review assigned Workqueues daily, which includes contacting insurance companies for status of claims, contacting patients for insurance verification, and contacting clinical departments for additional information needed to complete claims processing.
- Send letters to patients for COB issues.
- Initiate and follow-up of appeals, reopenings and inquires with insurances companies.
- Respond to department inquiries regarding claims adjudication as needed.
- Respond to correspondence received from patients or insurance carriers.
- Review daily, weekly and monthly reports and complete as necessary.
- Perform other job duties as assigned.
TYPICAL PHYSICAL DEMANDS:
Work requires sitting for extended periods of time, walking, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, type at 60 WPM, operate a calculator, telephone, copier, fax machine and other such office equipment as necessary. Hearing must be within normal range or correctable for telephone contact and conversation. It is necessary to view and type on computer screens for long periods, meet deadlines and work in an environment which can be very stressful.
TYPICAL WORKING CONDITIONS:
Work is performed in an office environment. Involves interaction with fellow staff in close conditions.
Experience
Required- Medical claim denial experience
- Epic knowledge
- CPT/ICD-10-CM/HCPCS knowledge preferred
Education
Required- High School or better
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)