Patient Account Specialist II (Accounts Receivable)

Tufts Medicine - Lawrence, MA

Full-time

Hybrid - Lawrence, MA

Ambulatory Health Care Services

About the position

The Patient Account Specialist II role focuses on revenue cycle operations, including billing, collections, and payment processing. This position is responsible for facilitating reimbursements for clinical services, submitting claims to health insurers, following up on claims, and performing appeals for non-clinical denials. The role requires a hands-on approach in a supportive environment, working under moderate supervision to ensure accurate and timely posting of cash payments and reconciliation of patient accounts.

Responsibilities

• Separate cash items from either lockbox or mail and prepare for posting.
• Compute remits, when necessary, and post cash payments to patient's accounts quickly and accurately as per procedure, balancing to control totals.
• Review, prioritize, research and resolve holding accounts in a timely and accurate manner.
• Follow up on all outstanding or incorrectly paid or rejected claims by utilizing the required reports, involving telephoning and/or rebilling the claims.
• Identify problems and discrepancies within the system, payer payment or policies and bring them to the supervisor's attention.
• Identify uncollectible accounts and write off to the appropriate write off code in a timely manner.
• Determine transactions and enter into GL either manually or through system access.
• Download, post and balance electronic remit advices accurately and timely.
• Correct and resubmit all accounts rejected during the download process.
• Process specific correspondence and telephone calls relating to follow up, adding new/corrected insurance information, editing accounts where necessary and billing/re-billing.
• Verify services with appropriate ancillary department when necessary.
• Take the initiative to meet the customers' needs and solve customers' problems, or find someone who can.
• Treat others with dignity, respect and compassion, respecting privacy of information and exercising good judgment about the dissemination of confidential information.
• Organize and prioritize 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.

Nice-to-haves

• Basic knowledge of job procedures and tools obtained through work experience.
• Vocational or technical education related to medical billing and collections.