Patient Financial Services Account Specialist (Accounts Receivable)

About the Job

Overview:

At Augusta Health, your work matters - and so do you. Whether you're delivering direct patient care, supporting operations, or innovating behind the scenes, every role contributes to our mission of promoting wellness and healing through compassionate service. We offer more than just a job - we offer a purpose-driven career in a nationally recognized, independent health system located in Virginia's scenic Shenandoah Valley.

Learn more about career opportunities on our Careers Page.

Our team members thrive in a supportive culture that values collaboration, integrity, and excellence. With opportunities across clinical and non-clinical areas, Augusta Health is a place where your skills make a difference, and your growth is a priority.

Why Join Augusta Health?

We believe in taking care of the people who care for our community. That's why Augusta Health offers a comprehensive and thoughtfully designed benefits package that supports your well-being, career development, and work-life balance. Whether you're launching your career or bringing in years of experience, we provide the tools, resources, and encouragement to help empower you to reach your full potential - personally, professionally, and financially.

Explore our Benefits, current Hiring Incentives, and our Taking Care of Us initiative - which embraces Belonging , Respect , Inclusion , Diversity , Growth , and Equity ( B.R.I.D.G.E. ) - to see how we invest in our team members and culture.

Total Rewards & Benefits (may vary by position):

• Comprehensive insurance package including medical, dental, and vision coverage.
• Retirement savings plans and financial wellness support programs.
• Generous paid time off and flexible scheduling to promote work-life balance.
• Career development programs including clinical ladders, shared governance, and advancement opportunities.
• Personalized onboarding with dedicated preceptors and ongoing educational support.
• Tuition reimbursement and access to onsite childcare.
• Free onsite parking, 24/7-armed security for your safety, a Health Fitness Reimbursement Program, and an onsite credit union and pharmacy.
• Competitive pay with shift/weekend differentials.
• Employee discounts at the cafeteria, gift shop, pharmacy, and local entertainment venues (i.e., movie tickets).

Full details are available on our Benefits Page.

Job Summary:

As a designated Accounts Receivables Specialist in Patient Financial Services, the incumbent will provide organizational support for the hospital and/or medical group in the patient accounting role through clean and accurate billing and collection activity to ensure prompt account resolution and cash flow optimization on hospital and/or physician accounts receivables management. In addition, this position actively supports and seeks to achieve departmental goals.

This position plays a critical role in supporting Augusta Health's mission and advancing departmental goals through measurable performance indicators and service excellence. This position contributes to a collaborative, patient-centered environment and helps drive outcomes aligned with organizational priorities.

Essential Job Duties:

The incumbent will be responsible for working daily task s generated within any/all of the departments receivables management computer systems including assigned pre billing edit rejected claims and unpaid denied claims through identifying, documenting and following up on problematic issues that prevented the successful and timely transmission of accurate/clean claims by a third party support partner as well as following up on denied claims by governmental and other third-party payers as assigned in the work queue.

Position is responsible for identifying and resolving invalid or missing claim data by communicating with the physician office practices, hospital clinical departments, compliance representatives, billing support personnel and/or other constituents to secure and correct the data which prevents or compromises the accurate transmission of the claim to the payer. Knowledge of the appeals process in researching denied claims to resolve discrepancies and correct claim data for re-billing.

Oversee assigned accounts receivable to ensure claims are being processed to completion through the following methods:

• Proactively generating aging reports through the appropriate billing system.
• Processing of unclean claims in a timely manner in the claims scrubbing system.
• Accurate and timely follow up on unresolved claims through communications with third party payers and patients, including electronic and verbal communication channels.
• Trouble shoot issues that surface to ensure timely resolution.

Monitor claims for denial trends and inform all parties involved including:

• Management.
• Office staff.
• Physicians.
• Department leaders.
• And Revenue Cycle leadership.

Maintain a working knowledge of all payer standard transactions sets, such as:

• 837 electronic claims processes.
• 835 electronic remittances processes and code sets.
• Electronic fund transferring, to ensure timely deposits of electronic payments.

Ensuring timely accounts resolution and optimization of cash flow:

• Knowledge of the appeals process in researching denied claims to resolve discrepancies and correct claim data for re-billing.
• Maintain working knowledge of multiple systems used in the day-to-day functions of the centralized business office.
• Prompt response to payer and patient correspondence.
• Provides regular feedback to management related to payer issues, provider office issues, and any other issues that will delay payment of claims.
• Ability to understand trends versus one off situations that may become a pattern.
• Keeping informed of new federal and state billing regulations any guidelines and report any issues to leadership.

Meets productivity standards as set by departmental policy in the areas of quantity of work and quality of work.

Other duties as assigned by Hospital and Physician Billing Manager, or Patient Accounting Director.

Required Qualifications:

• Education: High School Diploma or GED.
• Licensure/Certification: N/A.
• Experience: None.
• Driver's License: N/A.
• Eligibility to work in the United States and meet Virginia state employment requirements.

Preferred Qualifications:

• Education: N/A.
• Licensure/Certification: Certification through AAHAM, AAPC, HFMA or other nationally recognized revenue cycle association is desired, can be obtained on the job.
• Experience:
  • Medical or accounting experience.
  • Knowledge of third party and governmental billing/collection techniques.
• Prior experience in a hospital, healthcare system, or related service-oriented environment.
• Familiarity with Augusta Health's systems, workflows, or organizational culture is a plus.

Competencies, Knowledge, Skills and Abilities:

• Excellent computer and communication skills.
• Adaptable to change.
• Ability to problem solve.
• Strong time management.
• Experience in Microsoft Office products.
• Proactively prioritize needs.
• Articulates knowledge and understanding of organizational policies, procedures and systems.
• Work closely and professionally with all other staff members.
• Seeks to model process improvement.
• Identifies and reports potential issues at time of discovery.

About Augusta Health:

Augusta Health is an independent, nonprofit, mission-driven health system located in Fishersville, Virginia, in the heart of the Shenandoah Valley. We offer a full continuum of inpatient and outpatient services, including Augusta Medical Center a 255-bed facility and Augusta Medical Group, which operates 40 practice locations and four urgent care centers. Our commitment to excellence, innovation, and compassionate care makes Augusta Health a leading employer and healthcare provider in the region.

Discover more about our history, values, and community impact on our About Us Page.

Equal Opportunity Statement:

Augusta Health recruits, hires, and promotes qualified candidates for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran or military discharge status, and family medical or genetic information.

We are committed to fostering a diverse and inclusive workplace in accordance with federal and Virginia state employment laws.

About the Company

Exceptional care, small town hospitalityNestled in Virginia's beautiful Shenandoah Valley, Augusta Health is among the finest nonprofit community hospitals in America.Augusta Health opened in 1994 to continue a tradition of personalized care with small-town hospitality that began with predecessor hospitals in Staunton and Waynesboro. Today, our highly trained physicians and staff use state-of-the-art technology to provide top quality care with warmth and compassion. We offer many amenities so patients and families can be comfortable and close during difficult times. View Our Mission, Vision & Values.If you are a resident of Augusta County, Staunton, Waynesboro, or surrounding areas, you can benefit from a variety of programs we host to promote good health.If you are a dedicated healthcare professional, you will find exciting career opportunities at Augusta Health.Quick Stats for 2023Licensed for 255 beds124 Medical/Surgical14 Intensive Care Unit18 Labor and Delivery4 PediatricNon-traditional, Non-acute services28 bed psychiatric unit17 bed skilled nursing unit8 bed rehab unitLargest local private employerEmployees: 2,375+Active Physicians: 225APPs: 87Volunteers: 290Service Area: 200,000AH Urgent Cares: 5AH Practices: 49