Patient Account Specialist Job Description

Patient Account Specialist Job Description

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Patient account specialist provides support to hospitals on procurement questions including instrument identification, medical equipment accessories and common pharmaceutical terminology.

Patient Account Specialist Duties & Responsibilities

To write an effective patient account specialist job description, begin by listing detailed duties, responsibilities and expectations. We have included patient account specialist job description templates that you can modify and use.

Sample responsibilities for this position include:

Reviews account agings on a monthly basis and reports inconsistencies
Makes appropriate financial arrangements for payment of patient accounts
Performs reconciliation of refund accounts
Capably completes processing of claims on a daily basis by demonstrating in-depth knowledge of billing procedures by payer
Understands Claims Administrator and billing edits used to stop a claim from being transmitted electronically
Collects and enters any additional information relating to a patient account in a timely manner
Maintains files of correspondence, as necessary as evidenced by easy retrieval of a document based on the department retention policy
Ensures follow-up is done on all accounts/claims on their worklist on a daily/weekly basis
Ensures thorough follow-up is done on each account/claim by making all necessary contacts (phone calls, faxes, ) needed to obtain a payment date
Prioritizes work effectively in order to prevent backlogs

Patient Account Specialist Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Patient Account Specialist

List any licenses or certifications required by the position: TPE, BCLS

Education for Patient Account Specialist

Typically a job would require a certain level of education.

Employers hiring for the patient account specialist job most commonly would prefer for their future employee to have a relevant degree such as Associate and Bachelor's Degree in Associates, Education, General Education, Healthcare, Technical, Business, Medical, Health, Medical Billing, Graduate

Skills for Patient Account Specialist

Desired skills for patient account specialist include:

Insurance carriers
Managed care plans
Medical Terminology and Medicare Compliance
Government Payers and payer requirements
Medical terminology and insurance industry terminology
Standard medical abbreviations and medical terminology
Medical insurance practices and policies and regulations
Government and non-government uniform billing guidelines
Medical terminology and coding Related to hospital billing
Modifiers

Desired experience for patient account specialist includes:

REQUIRED) Minimum of 1yr of experience in a position directly related to revenue cycle / patient accounts, collections, insurance follow up and or patient access / registration
Bachelor’s degree, highly preferred (degree in progress ok)
Bachelor’s degree, highly preferred - in progress ok
Bachelor degree, highly preferred - in process ok
On patient approach
Degree, highly preferred - in progress ok

Patient Account Specialist Examples

1

Patient Account Specialist Job Description

Job Description Example
Our company is hiring for a patient account specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for patient account specialist
  • Enters payer information into CHHS software system(s) accurately and completely
  • Runs assigned reports regularly and completes follow up in areas of his/her responsibility in a timely manner
  • Demonstrates understanding and compliance of home care, hospice and home infusion rules and regulations along with knowledge of insurance companies' procedure
  • Obtains patient demographic information from network software systems, faxed information, hand written referral forms, and enters patient demographic information into agency software system(s) accurately, completely and in a timely manner
  • Performs all responsibilities with excellent customer service to internal customers, patients, families, physicians and referral sources
  • Assign accounts to outside collection agencies for further action
  • Maintaining current registration
  • Must know how to utilize Healthia and EEVE
  • Must know and recognize insurances and know how to utilize the insurance grid
  • Must be able to enter charges utilizing the Professional billing template in Excellian
Qualifications for patient account specialist
  • Coding, Billing, or Collections experience Preferred
  • Or Two years medical admitting, billing, collection or insurance experience
  • The above requirements may be met by the completion of a BA/BS degree
  • Identify payment sources for all services provided
  • Business Operations requires working several different types of work queues
  • Patient Registration WQs, Charge Review WQs, Claim Edit WQs, Patient Concern WQs, and Denial WQs are all part of our responsibilities
2

Patient Account Specialist Job Description

Job Description Example
Our company is hiring for a patient account specialist. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for patient account specialist
  • Resolves patient and customer billing issues, complaints and concerns by correctly answering questions
  • Researches and reviews patient accounts to determine accurate account information and updates the billing system with accurate account information
  • Documents and categorizes customer issues for further analysis
  • Recommends and processes customized payment plans according to established department guidelines
  • Performs and assists with other department duties as needed
  • Specific skills required as a Patient Services Resolution Representative must include the ability to process incoming and outbound calls with an emphasis on outbound calls, correspondence, attorney requests, email, voicemails, returned mail, self pay adjustments, charity adjustments and processing of payments
  • Works in collaboration with insurance payers and other revenue cycle departments to ensure proper reimbursement on patient accounts
  • Works follow up reports daily, maintaining established goal(s), and notifies Supervisor or Manager of all issues preventing timely reimbursement
  • Monitors specific assigned reports and assists team members regularly when advised by supervisor, providing feedback, ensuring both goals and job requirements are met as assigned by Supervisor and/or Manager
  • Performs and processes accurate billing and/or collection procedures to meet the needs of the department in order to ensure timely and accurate reimbursement is achieved on all outstanding assigned account receivable accounts
Qualifications for patient account specialist
  • Minimum of six (6) months billing, collections or accounts receivables required
  • Six (6) months in a call center environment preferred
  • Experience in the retail pharmacy and/or healthcare industries preferred
  • Previous experience preferred billing third party payers or working with providers to process claims
  • Must be able to follow written/oral instructions
  • High school diploma with a minimum of five years experience performing collection functions, preferably in a healthcare or patient care environment
3

Patient Account Specialist Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of patient account specialist. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for patient account specialist
  • Review assigned EOB’s and verify that appropriate financial class and plan code correspond with contract
  • Enter “balance represents” into patient accounting system based on appropriate contract with accuracy rate of 100%
  • Maintains an average of 100 accounts reviewed and balanced per day
  • Underpayments are referred to Denials Unit
  • Adjustments are entered daily and accurately
  • EOB’s with secondary insurance are referred to appropriate biller
  • Financial Class changes are entered in system accurately and timely
  • Credit Balance accounts are reviewed and processed for refunds
  • Insurance provider payment trends are identified and referred to Supervisor
  • Ensure all accounts on EOB’s are reviewed and documented according to Tenet Business Office guidelines of 3-days from date of posting and referred to collectors if needed
Qualifications for patient account specialist
  • Solid knowledge and understanding of healthcare collections and reimbursement practices required
  • Must be able to work in a team environment, prioritize and organize multiple tasks, and meet deadlines
  • Must be able to work a flexible work schedule to include evenings and weekends
  • At least 1 year of healthcare collections experience
  • This position requires demonstrated knowledge of medical terminology and Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9), Ninth Edition codes
  • Ability to establish effective working relationships excellent analytical, problem solving, and communication skills are required
4

Patient Account Specialist Job Description

Job Description Example
Our company is searching for experienced candidates for the position of patient account specialist. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient account specialist
  • Review accounts for special discounts (physician/employee/volunteer/reciprocal) and enter in system notes
  • Ensure that all billed invoices are adjudicated by insurance payor
  • Maintain assigned A.R
  • Answer all incoming telephone requests and correspondence accurately and timely
  • All inquiries from ancillary department staff, co-workers and supervisors are handled courteously and timely
  • Reviews account aging on a monthly basis and reports inconsistencies
  • Assist with compiling information for monthly management reports
  • Assist Supervisor with the interview process of potential employees
  • Reviews account agings and reports inconsistencies, correcting errors as appropriate
  • Contacts patients regarding delinquent accounts and calculates and documents mutually acceptable payment schedules
Qualifications for patient account specialist
  • Order to correctly accomplish required billing and follow-up procedures
  • Strong personal computer literacy required including working knowledge of relevant software packages such as Microsoft Office, Access, and Word
  • Keeps self-up to date on any up and coming Medicare changes or updates by dialing into monthly/ quarterly ask the contractor and other Medicare forums information on changes available on the Medicare website (Medicare Billing Specialist only)
  • Contact patients for pre-regsitration for surgery and complete workques
  • Knowledge of medical insurance and its terminology is helpful
  • General knowledge of basic ICD-10 and CPT coding is helpful
5

Patient Account Specialist Job Description

Job Description Example
Our growing company is looking for a patient account specialist. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for patient account specialist
  • Reviews and processes adjustments and refund requests
  • Ensures the review of EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends
  • Maintains payor profiles
  • Prepares and submits write-off requests with appropriate documentation
  • Processes insurance/patient correspondence, including denial follow-up
  • Provides guidance and daily work direction to business office staff
  • Resolving unpaid claims
  • Researching denials
  • Making out-bound status calls to payers
  • Reviewing payer websites for claim status
Qualifications for patient account specialist
  • Ability to effectively perform in a multi-task environment
  • Experience as an Outbound Call Agent or Collection Agent is desired
  • Position requires at least six months experience in as a Patient Services Account Representative (Outbound) or equivalent experience
  • Provide coverage in the Emergency Room registration areas, Outpatient Registration and Admitting areas
  • Support in Insurance Verification and the Radiology registration
  • Coordinate order release workflow

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