Job Information
Scripps Health Patient Account Specialist – Hospital Billing Governmental Services in San Diego, California
*This is a Full Time (80 hours every pay period) benefited position, Monday-Friday from 9AM-5:30PM. Over time additional hours when needed. *
Join the Scripps Health team and work alongside passionate caregivers and provide patient-centered healthcare. Receive endless appreciation while you build a rewarding career with one of the most respected healthcare organizations nationwide.
Why join Scripps Health?
/AWARD-WINNING WORKPLACE:/
- #5 in Fortune Best Workplaces in Health Care 2023
- #78 in 2023 PEOPLE Companies that Care
- #95 in Fortune 100 Best Companies to Work for 2023
- Recognized by Newsweek as one of America’s Greatest Workplaces for Diversity in 2024
- Nearly a quarter of our employees have been with Scripps Health for over 10 years.
As a Patient Account Specialist, you will be supporting the Billing Services department at our 4S Ranch Business Services location. This role is essential in managing a high volume of hospital Government Insurance/Billing documents, while also performing follow up actions to gather accurate information needed from patients, payers and providers. The ideal candidate is one who thrives in a fast-paced environment and has a passion for insurance and medical claims. As a Patient Account Specialist, you will be responsible for the following:
- Responsible for working aged reports and credit balances on a regular basis set by department guidelines.
- Follows-up with insurance carriers timely on unpaid claims until claims are paid or only self-pay balance remains. Does not have claims written off for timely filing.
- Processes rejections by either making accounts self-pay and generating a letter of rejection to patient or correct any billing error and resubmitting claims to insurance carriers.
- Keeps updated on all billing requirements and changes for all insurance types.
- Responsible for responding to all inquiries, billing denials, other correspondence and phone requests in an efficient, timely, and effective manner. Secures needed medical documentation required or requested by insurances.
- Works with HIM staff to ensure that complete diagnosis/procedure codes and modifiers are reported to insurance carriers as required.
- Working directly with the insurance company, healthcare provider, liable third parties, and patient to get a claim processed and paid
- Works to help maintain Accounts Receivable (AR) days at or near target level set by the Hospital Senior Team.
- Supporting continuous improvement of organization processes and personal knowledge and skills, and maintaining and protecting confidential information
- Providing excellent customer service through cooperative working relationships, and meeting productivity and quality standards.
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Required Education/Experience/Specialized Skills:
- Strong working knowledge of managed care plans, insurance carriers, government Payers and payer requirements.
- Knowledge of Medical Terminology and Medicare Compliance.
- Familiarity with HIPAA privacy requirements for patient information.
- Basic understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPC Codes.
- Ability to multitask and stay organized.
- Good verbal and written communication skills.
- Detail oriented and ability to prioritize work.
- Requires a moderate level of interpersonal, problem solving, and analytic skills.
- Knowledgeable on insurance and reimbursement process.
- Ability to establish/maintain cooperative working relationships with staff, Medical Staff and providers.
Preferred Education/Experience/Specialized Skills:
- Two years of patient accounts experience in a healthcare setting.
- Working knowledge of healthcare EPIC software preferred.
- Minimum two year experience billing Medicare, Medicaid, Blue Cross and Commercial insurance preferred, three or more years desired.
- Knowledge in Excel, Word and basic computer functions such as saving documents, sharing documents
- Demonstrate strong computer skills required. (Education may be substituted for experience in some areas.)
- Demonstrate knowledge of accounts receivable practices, payer billing and reimbursement procedures and practices.
- Working knowledge of hospital UB04, CPT-4, HCPCS, ICD-10 and Revenue codes.
- Proficient in institutional insurance billing guidelines using 837I X12 Version 005010X279A1 transactions.
Job: *Business Office
Organization: *Scripps Health Corp
Title: *Patient Account Specialist – Hospital Billing Governmental Services *
Location: Central San Diego County-SAN DIEGO-SCRIPPS CORPORATE OFFICES
Requisition ID: 252001474