About The Position

The Financial Assessor - Patient Accounting is responsible for ensuring timely resolution of claim edits, submission of compliant claims, and effective follow-up on third-party payer receivables. This role emphasizes adherence to regulatory standards, excellent customer service, and collaboration with the Patient Accounting team to achieve departmental goals.

Requirements

  • High School Diploma or equivalent.
  • 1 year of related work experience or a college degree.
  • Working knowledge of physician and facility billing and follow-up, especially Medicare and Medicaid regulations.
  • Knowledge of HIPAA standards.
  • Ability to perform mathematical calculations accurately.
  • Excellent communication skills for interaction with patients, families, and professional offices.
  • Basic knowledge of medical terminology and billing practices.
  • Extensive experience with PC applications, including Microsoft Office and Excel.

Nice To Haves

  • 2+ years of college or a college degree.
  • Experience in call centers, telephone work, or cash collections.
  • Knowledge of Epic Systems, Availity, EQ Health, and Clearing House.
  • Two years of progressive work experience in a hospital/physician billing or SBO environment.
  • Detail-oriented with good organizational skills and ability to be self-directed.
  • Strong time management skills and ability to manage multiple priorities in a high-stress environment.
  • Flexibility to perform various tasks in an active work environment.
  • High-level problem-solving, analytical, and investigative skills.
  • Excellent internal/external customer service skills.

Responsibilities

  • Meet productivity and quality standards in timely resolution of claim edits and submission of compliant claims.
  • Follow up and collect third-party payer receivables in a timely manner.
  • Conduct denials and appeals follow-up, including root cause analysis to reduce future denials.
  • Provide compliant follow-up correspondence to third-party payers regarding outstanding accounts receivables.
  • Support operations related to optimum third-party accounts receivables across various plans.
  • Perform daily reviews of work lists to ensure completion of all accounts ready to be worked.
  • Utilize government, commercial, and regulatory guidelines for collection of outstanding accounts.
  • Recommend accounts for write-off with appropriate justification and documentation.
  • Demonstrate excellent customer service through effective communication with patients and other contacts.
  • Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices.
  • Contribute to team efforts in achieving departmental accounts receivable goals.
  • Identify opportunities for customer, system, and process improvement and submit to management.
  • Utilize assigned systems and report any software or hardware issues to the appropriate supervisor.
  • Participate in testing for assigned software applications and assist with special projects as needed.
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