Patient Account Specialist Senior

Patient Account Specialist Senior

Location: 1600 Foster Street, Lake Charles, LA 70601 Employment Type: Contractor Onsite Openings: 1 Duration: 91 Days

Schedule: MondayFriday, 8 hours/day

Education Requirement: HS/GED NOT required

Medical Requirements: Required (per client process)

Skills: Collections, Insurance, UB-04, HCFA-1500, Reimbursement, Denials, Billing, Hospital Revenue Cycle, AR, TLRA

The Patient Account Specialist Senior is responsible for performing advanced collection activities to ensure accurate and timely reimbursement from commercial, governmental, and third-party payers. This role requires strong knowledge of inpatient and outpatient billing (UB-04, HCFA-1500), insurance claims processing, denial management, payer guidelines, and reimbursement methodologies. The specialist works extensively with multi-facility hospital billing, payer portals, and TLRA collections workflows. This role requires a high level of professionalism, accuracy, communication skills, and adherence to federal, state, and client-specific collection requirements.

Key Responsibilities

Insurance & Third-Party Collections

• Collect balances from commercial, governmental, and third-party payers following payer-specific processes.
• Work inpatient and outpatient billing using UB-04 and HCFA-1500 billing forms.
• Identify denied or underpaid claims and resolve them within payer turnaround guidelines.
• Maintain in-depth knowledge of payer contracts, claim processing rules, reimbursement methodologies, and appeal procedures.
• Review EOBs and ensure correct interpretation for proper payment application.

Denials & Resolution

• Research, appeal, and resolve claim denials and underpayments.
• Track trends causing recurring denials or delays in reimbursement.
• Communicate identified issues and recurring payer barriers to leadership.

TLRA Collection Unit Responsibilities

• Perform collection activities for accounts placed in TLRA inventory (both active AR and Client).
• Communicate professionally with patients, clients, vendors, and external reimbursement partners.
• Follow all TLRA, client, state, and federal regulations governing healthcare collections.

Documentation & Compliance

• Document all interactions, findings, and actions thoroughly and accurately in the appropriate systems.
• Maintain compliance with OneCHRISTUS competencies: Leader of Self, Leader of Others, and Leader of Leaders.
• Handle sensitive financial information with confidentiality and professionalism.

Required Qualifications & Skills

• Experience in a multi-facility hospital business office environment (required).
• Experience with inpatient & outpatient billing using UB-04 and HCFA-1500 forms.
• Insurance collections experience required.
• Strong knowledge of payer claim processing, appeals, and reimbursement models.
• Ability to use payer portals and interpret EOBs.
• Strong communication skills and ability to work with patients and external partners.
• Experience working with AR collections and TLRA processes preferred.
• Strong documentation accuracy and attention to detail.