Patient Financial Services (PFS) Account Specialist (Accounts Receivable Clerk (Healthcare), Patient Accounts Rep, Patient Billing Coordinator)

Overview

At Augusta Health your work matters and so do you. Whether youre delivering direct patient care supporting operations or innovating behind the scenes every role contributes to our mission of promoting wellness and healing through compassionate service. We offer more than just a job we offer a purpose-driven career in a nationally recognized independent health system located in Virginias scenic Shenandoah Valley.

Learn more about career opportunities on our Careers Page.

Our team members thrive in a supportive culture that values collaboration integrity and excellence. With opportunities across clinical and non-clinical areas Augusta Health is a place where your skills make a difference and your growth is a priority.

Why Join Augusta Health

We believe in taking care of the people who care for our community. Thats why Augusta Health offers a comprehensive and thoughtfully designed benefits package that supports your well-being career development and work-life balance. Whether youre launching your career or bringing in years of experience we provide the tools resources and encouragement to help empower you to reach your full potential personally professionally and financially.

Explore our Benefits current Hiring Incentives and our Taking Care of Us initiative which embraces Belonging Respect Inclusion Diversity Growth and Equity (B.R.I.D.G.E.) to see how we invest in our team members and culture.

Total Rewards & Benefits (may vary by position)

• Comprehensive insurance package including medical dental and vision coverage
• Retirement savings plans and financial wellness support programs
• Generous paid time off and flexible scheduling to promote work-life balance
• Career development programs including clinical ladders shared governance and advancement opportunities
• Personalized onboarding with dedicated preceptors and ongoing educational support
• Tuition reimbursement and access to onsite childcare
• Free onsite parking 24/7-armed security for your safety a Health Fitness Reimbursement Program and an onsite credit union and pharmacy
• Competitive pay with shift/weekend differentials
• Employee discounts at the cafeteria gift shop pharmacy and local entertainment venues (i.e. movie tickets)

Full details are available on our Benefits Page.

Job Summary

As a designated Accounts Receivables Specialist in Patient Financial Services the incumbent will provide organizational support for the hospital and/or medical group in the patient accounting role through clean and accurate billing and collection activity to ensure prompt account resolution and cash flow optimization on hospital and/or physician accounts receivables addition this position actively supports and seeks to achieve departmental goals.

This position plays a critical role in supporting Augusta Healths mission and advancing departmental goals through measurable performance indicators and service excellence. This position contributes to a collaborative patient-centered environment and helps drive outcomes aligned with organizational priorities.

Essential Job Duties

The incumbent will be responsible for working daily task s generated within any/all of the departments receivables management computer systems including assigned pre billing edit rejected claims and unpaid denied claims through identifying documenting and following up on problematic issues that prevented the successful and timely transmission of accurate/clean claims by a third party support partner as well as following up on denied claims by governmental and other third-party payers as assigned in the work queue.

Position is responsible for identifying and resolving invalid or missing claim data by communicating with the physician office practices hospital clinical departments compliance representatives billing support personnel and/or other constituents to secure and correct the data which prevents or compromises the accurate transmission of the claim to the payer. Knowledge of the appeals process in researching denied claims to resolve discrepancies and correct claim data for re-billing.

Oversee assigned accounts receivable to ensure claims are being processed to completion through the following methods:

• Proactively generating aging reports through the appropriate billing system.
• Processing of unclean claims in a timely manner in the claims scrubbing system.
• Accurate and timely follow up on unresolved claims through communications with third party payers and patients including electronic and verbal communication channels.
• Trouble shoot issues that surface to ensure timely resolution.

Monitor claims for denial trends and inform all parties involved including:

• Management
• Office staff
• Physicians
• Department leaders
• And Revenue Cycle leadership

Maintain a working knowledge of all payer standard transactions sets such as:

• 837 electronic claims processes.
• 835 electronic remittances processes and code sets.
• Electronic fund transferring to ensure timely deposits of electronic payments.

Ensuring timely accounts resolution and optimization of cash flow:

• Knowledge of the appeals process in researching denied claims to resolve discrepancies and correct claim data for re-billing.
• Maintain working knowledge of multiple systems used in the day-to-day functions of the centralized business office.
• Prompt response to payer and patient correspondence.
• Provides regular feedback to management related to payer issues provider office issues and any other issues that will delay payment of claims.
• Ability to understand trends versus one off situations that may become a pattern.
• Keeping informed of new federal and state billing regulations any guidelines and report any issues to leadership.

Meets productivity standards as set by departmental policy in the areas of quantity of work and quality of work.

Other duties as assigned by Hospital and Physician Billing Manager or Patient Accounting Director.

Required Qualifications

• Education: High School Diploma or GED
• Licensure/Certification: N/A
• Experience: None
• Drivers License: N/A
• Eligibility to work in the United States and meet Virginia state employment requirements

Preferred Qualifications

• Education: N/A
• Licensure/Certification: Certification through AAHAM AAPC HFMA or other nationally recognized revenue cycle association is desired can be obtained on the job.
• Experience:
  • Medical or accounting experience
  • Knowledge of third party and governmental billing/collection techniques.
• Prior experience in a hospital healthcare system or related service-oriented environment
• Familiarity with Augusta Healths systems workflows or organizational culture is a plus

Competencies Knowledge Skills and Abilities

• Excellent computer and communication skills
• Adaptable to change
• Ability to problem solve
• Strong time management
• Experience in Microsoft Office products
• Proactively prioritize needs
• Articulates knowledge and understanding of organizational policies procedures and systems
• Work closely and professionally with all other staff members
• Seeks to model process improvement
• Identifies and reports potential issues at time of discovery

About Augusta Health

Augusta Health is an independent nonprofit mission-driven health system located in Fishersville Virginia in the heart of the Shenandoah Valley. We offer a full continuum of inpatient and outpatient services including Augusta Medical Centera 255-bed facilityand Augusta Medical Group which operates 40 practice locations and four urgent care centers. Our commitment to excellence innovation and compassionate care makes Augusta Health a leading employer and healthcare provider in the region.

Discover more about our history values and community impact on our About Us Page.

Equal Opportunity Statement

Augusta Health recruits hires and promotes qualified candidates for employment without regard to age color disability gender identity or expression marital status national or ethnic origin political affiliation race religion sex (including pregnancy) sexual orientation veteran or military discharge status and family medical or genetic information.

We are committed to fostering a diverse and inclusive workplace in accordance with federal and Virginia state employment laws.

Required Experience:

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