Account Management Specialist

Position Summary:

The account management specialist is responsible for overseeing assigned patients accounts in full - which includes claims management (denial management, AR follow up, appeals, disputes, etc.) as well as patient account management (discussing account matters with families, sending invoices, setting up payment plans, etc.). The account management specialist will provide a high level of customer service to patients and families ensuring that all aspects of their accounts are managed.


Essential Functions:

• Investigate insurance denials timely and follow up on unpaid claims proactively
• Communicate effectively with insurance representatives and correct issues prior to re-submitting claims, with the goal of ensuring claims are paid correctly
• Appeal denials as necessary by submitting appropriate documentation to insurance carriers and following up regularly.
• Knowledge and experience of coordination of benefits
• Ensure patient account records are up-to-date and accurate.
• Facilitate insurance company correspondence, which may include medical records requests, denials of coverage, refund requests, etc.
• Communication with patient families related to insurance coverage and working outstanding balances.
• Research and resolve outstanding account balances, with an emphasis on maximizing patient satisfaction and practice profitability using the A/R aging reports
• Effectively monitor and manage accounts receivable and maintain within established goals and national benchmarks
• Post patient payments timely.
• Work with patient families to coordinate payment plans.
• Communicate with families when a payment plan is paid in full and document as necessary in Westside's systems.
• Manage and respond to emails from patient families and clinics timely and at least on a daily basis.
• Perform daily review of co-payments that cannot be electronically posted as they are processed and ensure posting is completed as soon as date of service is available for the payment to be applied.
• Generate and send invoices on a daily basis according to patient account schedules.
• Act as a resource to patients' families, striving to build client loyalty and confidence.
• Meet or exceed department goals set by lead or billing manager on a regular basis.
• Adhere to all practice policies related to HIPAA.

Required Education, Experience and Credentials:

• High school diploma or equivalent
• One year of billing experience in a medical office or healthcare setting

Knowledge, Skills and Abilities:

• Excellent interpersonal and communication skills
• Able to work effectively with all levels of the organization and in a diverse work group.
• Proactive and independent with the ability to take initiative.
• Excellent time management skills with a proven ability to meet deadlines.
• Comfortable with technology, with the ability to learn multiple systems and software.
• Proficient with Google Workspace
• Must maintain discretion and client confidentiality.

Personal Attributes:

• Interpersonal skills with strong verbal and written communication skills
• Process oriented with strong attention to detail and accuracy
• Accountability
• Integrity
• Problem Solving
• Initiative

Work Environment and Physical Demands:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.

Travel Requirements

• None

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.