Patient Account Specialist Resume Samples

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EE
E Effertz
Efren
Effertz
1376 Preston Well
Philadelphia
PA
+1 (555) 254 7714
1376 Preston Well
Philadelphia
PA
Phone
p +1 (555) 254 7714
Experience Experience
12/2015 present
Boston, MA
Medicare Patient Account Specialist
Boston, MA
Medicare Patient Account Specialist
12/2015 present
Boston, MA
Medicare Patient Account Specialist
12/2015 present
  • Develop and maintain positive working relationships with clinical personnel, teammates, and Payer representatives
  • Performance-based rewards based on stellar individual and team contributions
  • Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position
  • A comprehensive benefits package designed to enhance your health, your financial well-being and your future
  • Dedication, above all, to caring for patients suffering from chronic kidney failure across the nation
  • Stay up to date on communication relating to Medicare and CMS updates
  • Navigate through Medicare's Direct Data Entry claim system, and multiple internal systems to ensure timely and accurate resolution of outstanding claims
01/2009 07/2015
Houston, TX
Frx-patient Account Specialist
Houston, TX
Frx-patient Account Specialist
01/2009 07/2015
Houston, TX
Frx-patient Account Specialist
01/2009 07/2015
  • Applies copay assistance cards and other assistance information to patient profiles
  • Calls and emails FKC clinics to provide and obtain information pertinent to patient's medication orders
  • Applies Primary and Secondary Insurance to patient profiles
  • Develops and maintains effective relationships through effective and timely communication
  • Assist with various projects as assigned by direct supervisor
  • Addresses and resolves patient billing problems or concerns regarding copayments and authorization
  • Responsible for driving the FMCNA culture through values and customer service standards
09/2005 12/2008
San Francisco, CA
Patient Account Specialist
San Francisco, CA
Patient Account Specialist
09/2005 12/2008
San Francisco, CA
Patient Account Specialist
09/2005 12/2008
  • Provide exemplary customer service via telephone to patients, providers, business partners and co-workers
  • Identify payment sources for all services provided, assist in collecting payments, and triage patients or their representatives for financial counseling
  • Develop and maintain positive working relationships with clinical personnel, teammates, and insurance representatives
  • Act as an internal/external resource for all customer groups by providing access to healthcare services in accordance with established policies
  • Identify trends and perform root cause analysis on unpaid and underpaid claims
  • Works closely with collection agency to assure that they receive updated information on accounts as necessary
  • Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks
Education Education
Bachelor’s Degree in Creativity
Bachelor’s Degree in Creativity
University of South Florida
Bachelor’s Degree in Creativity
Skills Skills
  • Convey a strong professional image, exhibit interest and positive attitude toward all assigned work
  • A detail-oriented, customer-friendly self-starter with excellent communication and analytical skills
  • Knowledgeable in locating and referencing CMS and/or Medicare Regulations
  • Strong Math skills (ability to calculate figures and amounts)
  • Highly organized with detail and results orientation
  •  Strong team player; and
  • Strong Computer (Excel) and Keyboarding
  • Ability to prioritize and work with minimal supervision
  • Strong Microsoft Office skills (Word, Excel)
  • Ability to work in a fast paced environment
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11 Patient Account Specialist resume templates

1

Medicare Patient Account Specialist Resume Examples & Samples

  • Monthly reporting of outstanding accounts receivable
  • Stay up to date on communication relating to Medicare and CMS updates
  • Develop and maintain positive working relationships with clinical personnel, teammates, and Payer representatives
2

Patient Account Specialist Resume Examples & Samples

  • Strong Math skills (ability to calculate figures and amounts)
  • Strong Computer (Excel) and Keyboarding
  • Strong Numeric Data entry experience
  • Previous Payment Posting experience a plus
3

Patient Account Specialist Resume Examples & Samples

  • Provide exemplary customer service via telephone to patients, providers, business partners and co-workers
  • Excellent verbal and written communication – correct use of grammar, spelling and punctuation
  • (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, etc
  • (PREFERRED) 1yr of experience with Epic or similar EMR
4

Patient Account Specialist Resume Examples & Samples

  • Answers calls, voice mail and correspondence within department standards for account resolution
  • Follow up of unpaid accounts, review denied claims, unpaid claims and account balances. Enter or update notes on accounts as they are worked
  • Reviews and determines accuracy of demographics, insurance and billing data and updates as need to ensure proper and timely collections of accounts. Enter or update notes on accounts as they are worked
  • Work with insurance companies to resolve payment of claims via telephone, bring current or collect past due accounts, referring unusual account situations to higher management
  • Determine and take appropriate action for delinquency and non-payment of accounts
  • Uphold highest level of customer service, ability to a handle large volume of accounts, be a team player, a self-starter and have a strong work ethic, Works well independently as well as part of a team
  • Maintain and organize patient file documentation
  • Maintains knowledge of contracts, reviews billing and cash collected to ensure correct reimbursement
5

Frx-patient Account Specialist Resume Examples & Samples

  • Responsible for driving the FMCNA culture through values and customer service standards
  • Accountable for outstanding customer service to all external and internal customers
  • Develops and maintains effective relationships through effective and timely communication
  • Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner
  • Addresses and resolves patient billing problems or concerns regarding copayments and authorization
  • Calls Patients and FKC clinics for consent to ship orders and approval of copays
  • Calls and emails FKC clinics to provide and obtain information pertinent to patient's medication orders
  • Receives patient calls and resolves issues regarding patient copay balance
  • Answers questions from patients regarding most recent payments not reflected on statements
  • Answers general billing related questions
  • Takes patient payments for copays and copay balance
  • Applies Primary and Secondary Insurance to patient profiles
  • Applies copay assistance cards and other assistance information to patient profiles
  • Adjudicates insurance claims
  • Assists with Patient Service Coordinator duties, as needed
6

Patient Account Specialist Resume Examples & Samples

  • Provides effective collection services, ensuring the successful recovery of accounts in accordance with client and state guidelines as well as TLRA's business objectives
  • Understands and adheres to all policies and procedures, as well as local, state and federal regulations, relevant to their area of operation
  • Documents and updates patient account information in TLRA's collection software system timely and accurately to include appropriate account status
  • Handles inbound patient and/or carrier calls promptly and professionally, providing assistance and resolution to account inquiries, issues and request
  • Uses collection tools effectively to ensure quality recovery services and meet or exceed established goals and work standards
  • Performs research and analysis of account issues and strives to resolve problems timely and accurately
  • Ensure daily productivity standards are met
  • Promotes positive patient relations by communicating in a manner that demonstrates respect for the human dignity of patients and/or their families
  • Performs other special projects as required when assigned
  • HS Diploma or equivalency required
  • Post HS education preferred
  • Must have minimum of 3 years' experience with Medicare/Medicaid insurance billing, collections, payment and reimbursement verification and/or refunds
  • Experience with the Medicare billing process
  • Thorough understanding of Medicare/Medicaid guidelines and procedures for billing, collections and appeals
  • Understanding and exposure to Medicare Recovery Audit Contractor
  • Knowledgeable in locating and referencing CMS and/or Medicare Regulations
  • General hospital A/R accounts knowledge is required
  • PC skills in a Windows environment are required. Solid knowledge and utilization of desktop applications to include Word and Excel are essential
  • College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience
7

Patient Account Specialist Resume Examples & Samples

  • Knowledge of medical terminology, reimbursement and coding required
  • Computer data entry or word processor experience desired
  • Must have professional telephone manner
8

Patient Account Specialist Resume Examples & Samples

  • Performs audits of patient accounts to ensure accuracy and timely payment
  • Reviews account agings on a monthly basis and reports inconsistencies; corrects errors as appropriate
  • Contacts patients regarding delinquent accounts and arranges mutually acceptable payment schedules
  • Demonstrates the ability to deal with patients regarding sensitive financial matters and recapture unpaid balances
  • Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments
  • Reviews appropriate files to identify deceased patients and estates; verifies dollar amounts and files estate to appropriate court in a timely manner
  • Makes appropriate financial arrangements for payment of patient accounts; follows up to determine if payment arrangements are being met; contacts patients to resolve problems; responds to correspondence or telephone calls from patients about accounts
  • Prepares write-off requests with appropriate documentation and submits to supervisor
  • Processes insurance/patient correspondence, including denial follow-up within 48 hours of receipt. Files all reimbursement correspondence daily
  • Works with provided aging to monitor patient account agings and follow up appropriately
  • Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation
9

Patient Account Specialist Resume Examples & Samples

  • Follows up on insurance billing to ensure timely receipt of payments
  • Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances
  • Reviews credit balance reports for correct recipient of refund
  • Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks
  • Identifies problems on accounts and follows through to conclusion
  • Responds to insurance companies requests for information in a prompt and professional manner
  • Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor
  • Resubmits insurance claims within 72 hours of receipt
  • Participates in maintaining Payor Manuals/Profiles
  • Works closely with collection agency to assure that they receive updated information on accounts as necessary
  • Works with provided aging to monitor patient account agings and follows up appropriately
10

Frx-patient Account Specialist Resume Examples & Samples

  • Excellent customer service and interpersonal skills required
  • Proficient in the use of computers and related software, such as Microsoft Office Suite (Excel and Word)
  • Ability to learn and apply basic skills needed to work with pharmacy systems
  • Ability to learn and adopt established billing practices and policies
  • Ability to interpret an extensive variety of technical instructions and convey those to others
  • Ability to maintain patient confidentiality at all times
  • Dependable, focused and professional at all times
  • Detail oriented and able to work under deadlines
  • Analytical and able to apply proper research and critical thinking to interpret and resolve billing and collection issues
  • Excellent organizational and analytical skills
  • Detail oriented with the ability to enter information accurately on paper and into a database system
  • Develops a working knowledge of standard medical abbreviations and medical terminology
11

Patient Account Specialist Resume Examples & Samples

  • One or more years’ experience in a patient accounts or business office setting for a hospital, physician's office, or other medical setting
  • A detail-oriented, customer-friendly self-starter with excellent communication and analytical skills
  • Ability to work in a fast paced environment and stay on task
  • Computer skills with an ability to use a Windows-based operating system
  • Working knowledge of patient scheduling, medical insurances and billing processes
12

Patient Account Specialist Resume Examples & Samples

  •  Answers calls, voice mail and correspondence within department standards for account resolution
  •  Follow up of unpaid accounts, review denied claims, unpaid claims and account balances. Enter or update notes on accounts as they are worked
  •  Reviews and determines accuracy of demographics, insurance and billing data and updates as need to ensure proper and timely collections of accounts. Enter or update notes on accounts as they are worked
  •  Work with insurance companies to resolve payment of claims via telephone, bring current or collect past due accounts, referring unusual account situations to higher management
  •  Determine and take appropriate action for delinquency and non-payment of accounts
  •  Uphold highest level of customer service, ability to a handle large volume of accounts, be a team player, a self-starter and have a strong work ethic, Works well independently as well as part of a team
  •  Maintain and organize patient file documentation
  •  Maintains knowledge of contracts, reviews billing and cash collected to ensure correct reimbursement
  •  The ability to maintain friendly, cordial relations with all clients and employees
  •  The ability to maintain friendly, cordial relations with all clients and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers
  •  Ability to comply with ATI standards of operations
  •  Utilize proper response letters on computer for various incoming correspondence
  •  Conflict management
  •  Priority setting
  •  Timely decision making
13

Patient Account Specialist Resume Examples & Samples

  • Capably completes processing of claims on a daily basis by demonstrating in-depth knowledge of billing procedures by payer. Ensures that there are no claims older than 5 days in their CA queue
  • Understands Claims Administrator and billing edits used to stop a claim from being transmitted electronically. Understands how to research information needed on a per claim basis and how to correct the claim in the McKesson system (either Plus or Star) and follows all procedures related to CA
  • Collects and enters any additional information relating to a patient account in a timely manner. Ensures the Plus and/or Star system is always updated to accurately reflect the current status of an account
  • Ensures all mail/correspondence is worked and remains current on a weekly basis. Communicates any backlogs to their supervisor or lead prior to the end of the week
  • Maintains files of correspondence, etc. 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 that all claims/accounts have no follow-up dates that fall into previous months
  • Ensures thorough follow-up is done on each account/claim by making all necessary contacts (phone calls, faxes, etc.) needed to obtain a payment date. Calls and verifies that payment will be made by utilizing an appropriate future follow-up date in Star or Plus
  • Prioritizes work effectively in order to prevent backlogs. Communicates workload issues to supervisor or lead. Helps other work group partners to avoid backlogs
14

Senior Patient Account Specialist Resume Examples & Samples

  • Responsible for maintaining departmental standards as defined and productivity with a strong focus
  • Demonstrate a strong knowledge of third party payers including Medicare, Medicaid and local HMO/PPO’s
  • Liaison for CBO staff and management to resolve patient account issues that cannot be resolved
  • Maintain working knowledge of the current billing office system and perform ongoing training to
  • Ability to provide ongoing monitoring of standards by conducting monthly audits
  • Utilize proper response letters on computer for various incoming correspondence
  • At least 2 years of healthcare billing and collections experience
15

Satellite Patient Account Specialist Resume Examples & Samples

  • This position requires demonstrated knowledge of medical terminology and Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9), Ninth Edition codes; billing practices and workflows; ability to maintain current knowledge of payer billing requirements in relation to correct coding
  • Ability to establish effective working relationships as well as excellent analytical, problem solving, and communication skills are required
  • Requires basic accounting/math skills; excellent customer service skills; the ability to handle multiple tasks and high volumes of work including constantly reprioritizing work with ease; and the ability to work with minimal supervision
16

Patient Account Specialist Resume Examples & Samples

  • Familiar with insurance verification processes with Mental Health coverage
  • Investigative /Problem solving skills
  • Experience verifying insurance benefits on-line websites
  • Strong Microsoft Office skills (Word, Excel)
  • Ability to prioritize and work with minimal supervision
  • Highly organized with detail and results orientation
  • Ability to deal with all levels of stress and handle crises situations
  • Frequent bending and sitting
  • Extensive periods of telephone contact
  • Frequent reading, writing, and computer use
17

Patient Account Specialist Resume Examples & Samples

  • Maintain accurate electronic medical records and abide by all internal and governmental/regulatory compliance expectations
  • Basic knowledge of medical terminology and insurance industry terminology preferred
  • Typing speed of 30 wpm required, one year of computer experience required