Accounts Resolution Specialist I
Job ID: 181828
Category: Accounting/Finance
Work Type: FT
Location: Philadelphia, PA, United States
Date Posted: May 15, 2023
Work Schedule: Full Time
Description
Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
Accounts Resolution Specialist I
Clinical Practices of University of Pennsylvania
3400 Spruce Street
Summary:
The Account Resolution Specialist I reports to the Supervisor of Billing; primary responsibilities are to facilitate activities necessary to a successful resolution of accounts. This position will work out of assigned work queues handling claim edit work queue resolution as well as follow up work queue denials transferred from Professional Billing Office that require department intervention. Individuals will be responsible for investigating claim denials and underpayments by insurance carriers and appeal for payment or make appropriate adjustment. Exercising good judgement in escalating identified denial trends or root cause of denials to mitigate future denials, expedite the reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate a first pass resolution.
Responsibilities:
- Responsible for patient account research in relation to working accounts within the claim edit work queue and follow-up work queue.
- Identifying untimely accounts and performing accurate and timely write offs adhering to policy guidelines.
- Responsible for maintaining the highest level of billing standards following current guidelines from Medicare, Medicaid, and other insurance entities.
- Answering revenue cycle patient inquiries as well as front desk questions regarding patient accounts.
- Meets or exceeds established performance targets (productivity and quality) established by the Supervisor of Billing.
Education or Equivalent Experience:
- H.S. Diploma/GED required.
- 3+ years working in health care (professional) billing, health insurance or equivalent.
Skills and Abilities:
- Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, government, managed care and commercial insurances, claim submission requirements, reimbursement guidelines, and denial reason codes required.
- Knowledge of other front-end processes, including scheduling, pre-registration, financial counseling, and registration required.
- Efficient time management skills and ability to multitask preferred.
- Strong computer literacy skills including proficiency in Microsoft Office preferred.
- Excellent organization skills, attention to detail, research and problem solving ability preferred.
- Results oriented with a proven track record of accomplishing tasks within a high-performing team environment preferred.
Live Your Life's Work
We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
