Account Specialist I

Job Description

Job Overview:

The major purpose of this position is to expedite positive cash flow, maximize reimbursement, and reduce or eliminate financial loss to department customers by accurate efficient timely billing, follow-up and collections of patient accounts. Duties include: In charge of the timely and accurate follow-up on all patient account balances; In charge of processing the specified number of accounts on a daily basis based on customer specialty and unique billing requirements; In charge of understanding both Government & Non Government Contractual billing and Follow-up guidelines, based on individual payers; Responsible for contacting Government, Non Government & Self payers regarding lack of payment or improper payment; Resolves all incorrect payment issues and ensures that balances after insurance payments are correct based on contracts with individual payers; Displays quality customer service to internal/external customers, by providing timely/accurate information, and works to ensure that problems are resolved.

Job Requirements:

High School Degree
Proficient in EDI/PC applications
1-2 years experience in a related field

Job Responsibilities:

Collects insurance and self-pay dollars outstanding through interactions with payers and patients. Participates willingly in payer communications and supports other in sharing information and keeping others up to date. Prepares monthly status reports for submission to senior management. Reduce the outstanding accounts receivable associated with each assigned customer book of business as measured by cash collections and days in accounts receivable.


Responds to written and oral inquiries from customer contacts and insurance companies. Works insurance denials on a daily basis in order to identify errors, correct errors and resubmit claims for payment. Looks for trends and tracks statistics.

Other job-related information:

Working Conditions:

Climbing - Rarely
Hearing: Conversation - Consistently
Hearing: Other Sounds - Frequently
Kneeling - Occasionally
Lifting 50+ Lbs. - Rarely
Lifting <50 Lbs. - Occasionally
Pulling - Rarely
Pushing - Occasionally
Reaching - Rarely
Sitting - Consistently
Standing - Rarely
Stooping - Occasionally
Talking - Consistently
Use of Hands - Consistently
Color Vision - Occasionally
Visual Acuity: Far - Frequently
Visual Acuity: Near - Consistently
Walking - Frequently

TriHealth SERVE Standards and ALWAYS Behaviors
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:


Serve: ALWAYS...
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS...
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service
Respect: ALWAYS...
• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone's opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS...
• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS...
• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community