Patient Account Specialist II (Accounts Receivable)

Tufts Medicine - Lawrence, MA

Full-time - Mid Level

Hybrid - Lawrence, MA

Ambulatory Health Care Services

About the position

The Patient Account Specialist II (Accounts Receivable) at Tufts Medicine is a vital role within the revenue cycle operations, focusing on billing, collections, and payment processing. This position is responsible for facilitating the reimbursement for clinical services provided to patients, which includes submitting claims to health insurers, following up on submitted claims, and performing appeals for non-clinical denials. The role operates in a hybrid working model, requiring onsite presence once a week at the Lowell, Massachusetts location. The position entails a structured work schedule of 40 hours per week, from Monday to Friday, 8:00 AM to 4:30 PM, with an initial training period of 2-3 weeks conducted onsite. In this role, the specialist will spend the majority of their time delivering support services or activities under moderate supervision. The responsibilities include accurate and timely posting of cash payments and rejection messages to patient accounts, as well as reconciling these accounts in accordance with established policies and procedures. The position requires a basic knowledge of job procedures and tools, which can be obtained through work experience or vocational education. The specialist will also be expected to communicate information that may require some explanation or interpretation, and to identify and resolve discrepancies within the billing system. The Patient Account Specialist II will engage in various tasks such as separating cash items for posting, computing remits, reviewing and resolving holding accounts, and following up on outstanding claims. The role demands excellent communication and interpersonal skills, as well as the ability to work independently and as part of a team in a fast-paced environment. Attention to detail is crucial to ensure that all correspondence is accurately distributed and that customer needs are met with professionalism and respect.

Responsibilities

• Separates cash items from either lockbox or mail and prepares for posting.
• Computes remits, when necessary, and posts cash payments to patient's accounts quickly and accurately as per procedure, balancing to control totals.
• Reviews, prioritizes, researches, and resolves holding accounts in a timely and accurate manner.
• Follows up on all outstanding or incorrectly paid or rejected claims by utilizing the required reports, involving telephoning and/or rebilling the claims.
• Identifies problems and discrepancies within the system, payer payment or policies and brings them to the supervisor's attention.
• Identifies uncollectible accounts and writes off to the appropriate write off code in a timely manner.
• Determines transactions and enters into GL either manually or through system access.
• Downloads, posts, and balances electronic remit advices accurately and timely.
• Corrects and resubmits all accounts rejected during the download process.
• Processes specific correspondence and telephone calls relating to follow up, adding new/corrected insurance information, edits accounts where necessary and bills/re-bills.
• Verifies services with appropriate ancillary department when necessary.
• Takes the initiative to meet the customers' needs and solve customers' problems, or finds someone who can.
• Treats others with dignity, respect, and compassion, respecting privacy of information and exercising good judgment about the dissemination of confidential information.
• Organizes and prioritizes responsibilities to complete work assignments; completing priority assignments promptly.

Requirements

• High school diploma or equivalent.
• Two (2) years of experience in an automated medical billing and collection environment for a medical services provider and/or third-party payer.
• Excellent communication skills and the ability to effectively communicate with all areas of Patient Financial Services as well as Revenue Cycle.
• Excellent interpersonal skills with the ability to react in a professional manner.
• Ability to work independently and as part of a team in a fast-paced environment.
• Maintains current knowledge of rules and regulations governing third party payers and working knowledge of various billing tasks.
• Ability to use computerized billing and A/R systems and various PC based programs (Excel, MS Word).
• Organizational and time management skills to complete tasks within a specified time.
• Ability to develop and maintain professional, service-oriented working relationships with leadership, patients, and co-workers.
• Attention to detail to ensure correspondence is distributed to appropriate areas of Revenue Cycle.

Nice-to-haves

• Experience with team management concepts.
• Familiarity with various billing tasks and third-party application systems.