Patient Services Specialist

Job Purpose:

Maintenance of private Insurance accounts for patient billing and to assist the AR Manager/Supervisor in managing the Accounts Receivables for the physicians/clinics/clients that are assigned to them, by reducing the AR, resolving claim denials, and following payer specific processes surrounding the AR while managing their assigned task EPM inventory.

Responsibilities:

• Answer incoming calls
• Run & Process Statements, as per client preference
• Work returned mail
• Convey balances, if applicable
• Provide feedback to team lead regarding denial trends
• Maintain strict confidentiality within medical practice and HIPAA compliance
• Maintain productivity standards and goals set by the department and/or manager.
• Maintain standard quality measures and goals.
• Attend Meetings as required and/or participate in various committees as required
• Other duties as assigned by, Team Lead, Manager, Director, VP RCM.

Required Skills:

• High school diploma/GED
• Preferably two years’ prior experience in physician professional billing (Managed Care, Commercial and or CMS Part B claims adjudication, including but not limited to:
• Explanation of Benefit forms (EOB)
• Credit balances (discounts and refunds)
• Insurance carrier billing requirements
• Collections
• Familiarity of payer provider enrollment
• CPT & ICD10 Coding

Core Competencies:

Accountability and Self-Management

• Must be detail-oriented and organized
• A self – starter capable of tracking to deadlines and meeting goals with little supervision required
• A high level of analytical and problem solving skills is expected

Team Player

• Ability to work autonomously and as a team player

Communication

• Excellent communication, customer service, and organizational skills
• Strong verbal and written communications

Innovation and Problem Solving

• Attention to detail and moderate analytical and problem solving skills is expected

Computer Skills

• Must possess general office skills and computer knowledge
• Strong working knowledge of the Aprima PM practice management system and/or GE Centricity Business system and coordinating modules, is preferred
• MS Excel Spreadsheet software, MS Word Processing software

Physical Demands:

• May require sitting for long periods of time; also, stooping, bending, and reaching for files and supplies.
• Requires manual dexterity sufficient to operate a computer keyboard, answer a telephone, and run a copier and other office equipment as necessary.
• Employee must participate to help maintain the desirable work environment created by the management and company officials.