Patient Account Specialist-Full Time-Days
Cape Fear Valley Health · CFV
Facility
Cape Fear Valley Medical CenterLocation
Fayetteville, North CarolinaDepartment
Patient Financial Services OperationsJob Family
ClericalWork Shift
Days (United States of America)Summary
Handles the complete processing of patient accounts with third party carriers from start to finish to include but not limited to: billing the claim either electronically or paper, supplying additional information necessary for claim adjudication, and answering patient and insurance company questions.Major Job Functions
The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:
Submits primary insurance claims to all carriers using the electronic claims terminal or send hard copy claims
Uses the on-line work list and account referrals to review accounts that are pending payment from insurance companies for additional information
Validates the accuracy of patient information so that future billing and follow-up activities are conducted effectively and to ensure a high degree of customer service.
Applies adjustments and write-offs to accounts according to policy and procedure to assure accurate account balances and statements
Maintains a suspense file of accounts that need additional documentation for eligibility determination prior to billing
Receives incoming calls from patients and/or insurance companies concerning open accounts and answers questions and provides information in a courteous and cooperative manner to maintain good customer relations
Other duties as assigned
Minimum Qualifications
The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:
Education and Formal Training:
High school diploma or equivalent required
Work Experience:
2 years’ experience with electronic hospital billing or collections in a medical field required
1 year of experience with personal computer software and other office equipment required
1 year of medical terminology and familiarity with CPT-codes, ICD-10 codes and HCPCS codes preferred
Knowledge, Skills, and Abilities Required:
Proficiency in reading, writing, and speaking the English language
Knowledgeable in third party claim adjudication to include: Medicare, Medicaid, Tricare, commercial insurance, and managed care
Must pass departmental training (calculating reimbursement, UB-04, Patient Account Terms and System Navigation) tests 75% or higher
Excellent verbal and written communication skills
Analytical ability and accurate mathematical calculation skills
Physical Requirements:
Near visual acuity required
Motor coordination and finger dexterity required to complete repetitive functions with computer and other office equipment
Ability to lift twenty-five pounds
Ability to talk and to receive information by telephone is required
Required Licenses and Certifications
Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity
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