Patient Account Specialist

Principal Duties and Responsibilities:

• Maintain patients accounts including: verifying patient demographic information is populated ensuring all guarantors are entered correctly creating a supervision relationship or patient responsibility if appropriate completing authorization reports adding new payer information verifying benefits controlling patient balances and verifying patients are scheduled with a participating provider.

• Contact insurance companies to obtain preauthorization resolve outstanding balances incorrect payments claim denials or information needed to adjudicate claims. Work with clinical areas to resolve rejections and determine collectability or need for adjustment.

• Responsible for Medicaid/Medicare reporting. Ensure that patients have necessary agreements on file.

• Process any failed claims assuring claims meet the clean claim definition to assure timely and accurate payment.

• Apply patient payments to accounts monitoring for compliance with contractual agreements to assure appropriate reimbursement for services provided. Prepare and balance bank deposits.

• Answer patient questions regarding balances make referrals to other areas as appropriate i.e. clinical area Patient Rights etc. Create and maintain customer-friendly environment with internal and external customers.

• Establish payment arrangements within established guidelines.

• Review accounts to determine patient delinquency and initiate collection steps or refer to collection agency.

• Responsible for the monitoring and careful use of resources impacting them in a moderate capacity (i.e. writing off balances application of PAF funds etc.).

• Responsible for the application of PAF funds and entry of PAF data.

• Maintain knowledge of payer regulations contracts and billing requirements and act as a resource to clinical sites regarding these requirements.

• Offers or delegates administrative support including but not limited to the following tasks: greeting answering questions based on knowledge scanning and copying letters of correspondence monitoring clinical staff schedules (i.e. referral scheduling maintaining of cancellation list and coordinating model of care appointments) and front desk duties (i.e. check in/out of patients answering and triaging patient phone calls and opening/closing responsibilities).

• Medical dental vision & life insurance plans

• 403(b) retirement match contribution by Pine Rest

• Generous PTO for full and part time employees

• Tuition assistance & loan forgiveness

• Employee Assistance Program offering many free and discounted services for therapy legal accounting gym membership etc.

• Partnership with Davenport University provides generous discount on tuition for employees and family members.

Notice:

Pine Rest provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race color religion age sex national origin disability status genetics protected veteran status sexual orientation gender identity or expression or any other characteristic protected by federal state or local laws.

All new employees are subject to a criminal background check and education verification which may include sending a copy of your high school diploma GED or college transcripts.

Successful completion of a drug screen prior to employment is also part of our background process.

Pine Rest Christian Mental Health Services requires all employees to receive the COVID-19 vaccinations subject to certain exclusions. Pine Rest is committed to granting reasonable accommodations in accordance with applicable laws.