Patient Account Specialist
USPI
Patient Account Specialist
North Central Surgical Center is a highly successful, Baylor Scott & White affiliated hospital located in Dallas, TX. We partner with the very best team members and medical staff in the area. We are a surgical focused hospital that performs over 12,000 procedures per year. Opened in 2005, 14 Operating Rooms and 30 Medical/Surgical Patient Rooms. We are conveniently Located at Walnut Hill & 75 in the prestigious NorthPark area Specialties include: Orthopedics, Spine, General Surgery, Pain Management, Urology, GI/Endoscopy, Plastic, and Podiatry surgeries. Managed by United Surgical Partners International & Joint Commission Accredited
Under the direction of the Director of Business Office or Revenue Cycle Management (RCM) team, the Patient Account Specialist is responsible for performing follow-up functions to ensure timely and accurate collection of patient accounts. This position involves answering patient inquiries regarding statements, managing insurance follow-ups, auditing accounts, and handling billing and collections activities. The Patient Account Specialist will work collaboratively with patients, insurance carriers, and internal departments to ensure compliance, efficiency, and accuracy in managing patient accounts.
Account Management:
- Perform account follow-up with patients to ensure maximum and correct reimbursement of patient accounts.
- Proactively work with payers and in-house resources to resolve patient accounts in a timely manner.
- Maintain accurate records of patient payments, ensuring that all credit card information is handled securely and destroyed appropriately.
- Manage account follow-up with insurance providers to verify claim status, manage billing, and ensure claims are correctly filed, corrected, and re-billed as necessary.
Insurance and Billing:
- Review accounts to determine the correct financial liability between the patient and the insurance provider.
- Work with insurance carriers to resolve unpaid claims, including conducting follow-up on appeals, adjustments, and denials.
- Utilize research and analytical skills to interpret complex hospital-managed care contracts to ensure appropriate reimbursement.
- Record and update information about the status of claims, including documenting denial and group information.
Patient Interaction:
- Handle inquiries from patients regarding statements, payment options, and account status in a courteous and professional manner.
- Take patient payments over the phone using credit card or electronic funds transfer (EFT).
- Communicate effectively with patients, visitors, physicians, and office staff to ensure exceptional customer service.
Documentation and Reporting:
- Enter comments into the patient accounting system (e.g., Cerner) related to the collection of accounts.
- Mail form letters to insurance carriers to encourage payments on outstanding claims and confer with carriers by telephone to resolve payment delays.
- Maintain HIPAA standards by ensuring patient, physician, and employee privacy and confidentiality.
Collaboration and Compliance:
- Attend in-services, conferences, and meetings as required, including annual safety and competency education sessions.
- Serve as a resource to other members of the healthcare team and assist with additional responsibilities as deemed necessary by management.
Required Skills:
Education: High school graduate or equivalent required. Some college coursework in business, finance, or a related field is preferred.
Licensure/Certification: None required, but certification in medical billing, coding or healthcare finance is a plus.
Specific Job Experience: Minimum of 1 year of experience in a hospital or healthcare clerical role, patient accounts, billing, or collections. Experience with managed care contracts and knowledge of medical billing processes is preferred.
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