Overview
The Patient Account Specialist Senior plays a crucial role in the healthcare organizations revenue cycle management by overseeing the billing and payment process. This position requires a thorough understanding of healthcare financial systems compliance regulations and medical coding practices to ensure accurate and efficient claims management.
Key Responsibilities
- Manage and resolve complex patient accounts and billing issues
- Review analyze and process insurance claims and rejections
- Ensure compliance with billing and coding regulations
- Collaborate with medical staff and insurance companies to resolve payment discrepancies
- Provide training and guidance to junior staff on billing processes
- Identify opportunities for process improvement and revenue optimization
- Monitor accounts receivable and follow up on outstanding balances
- Generate financial reports and analysis for management review
- Assist in the implementation of new billing and coding procedures
- Respond to patient inquiries and provide information on billing and account status
- Participate in audits and compliance reviews
- Stay updated on changes in healthcare billing and coding guidelines
- Collaborate with crossfunctional teams to resolve billingrelated issues
- Ensure accurate and timely submission of claims to insurance providers
- Handle escalated customer inquiries and complaints
Required Qualifications
- Bachelor s degree in Healthcare Administration Business or related field
- 3 years of experience in healthcare revenue cycle management
- Demonstrated proficiency in medical billing and coding
- Knowledge of healthcare compliance regulations (HIPAA OIG etc.)
- Experience working with healthcare billing software and EMR systems
- Strong analytical and problemsolving skills
- Excellent communication and interpersonal abilities
- Ability to work under pressure and meet deadlines
- Certification in Medical Billing and Coding (e.g. CPC)
- Thorough understanding of insurance verification and eligibility
- Familiarity with ICD10 CPT and HCPCS coding systems
- Detailoriented with a focus on accuracy in financial data
- Proficient in MS Office especially Excel and Word
- Ability to adapt to changes in healthcare billing practices
- Strong knowledge of healthcare reimbursement methodologies
communication,compliance,medical coding