Overview MEDNAX has grown from a single medical practice to a trusted health solutions partner with more than 10,000 employees and a presence in 50 states. Through our family of companies, we provide: physician services spanning the continuum of patient care• revenue cycle management solutions• performance improvement consulting We invite you to grow with us and help shape the future of health care. The Patient Accounts Specialist is responsible for covering for employee absences, and special projects. The Patient Account Specialist should be capable of temporarily filling any key position within Patient Accounts during, employee absences for vacation, FMLA, or during the recruitment process if necessary. The Patient Account Specialist may work collection reports and correspondence, audit accountsand/or appeal denied claims as necessary. When the Patient Account Specialist is not engaged in temporary coverage their work will be assigned by the Regional Manager. Responsibilities 1. Covers job assignments on as-needed basis. Accepts job assignments based on the need of the department and the critical nature of the position open, under the direction of the Regional Manager. Maintains proficiency in knowledge and skills to cover all aspects of specific jobs, such as: Underpayment Specialist, Commercial Appeals Specialist, Billing Analyst and Customer Service Coordinator. Qualified to assist with any open position in Patient Accounts, or temporary vacancy within Patient Accounts. When filling temporary vacancy, provides Regional Manager, Collection Manager, and lead with summary status report weekly/monthly as requested by manager. Requests training as needed to be effective in each assignment. 2. Make necessary telephone or written contact. Contact payers to check claim status and reimbursement. Contact parents to obtain accurate insurance information. Phone appeals on denied claims. Contact payer regarding carrier issues. Provide Call Center backup as needed. Send appropriate letters. 3. Perform audits on accounts when needed. Review accounts for accuracy (ie; payments have been posted correctly, appropriate adjustments have been made, etc.). Process refunds for overpayments made by payers and patients. Process adjustments as necessary (ie; contractual, good faith, settlement, etc.). 4. Appeal denied claims – (via mail or telephone). Request Accounts Receivable Status Reports when a denial trend has been identified. Review Accounts Receivable report detail for denial trends. Obtain Medical Records from Hospital Associates and send them to the payer. Review diagnosis and procedure codes with the Coding Department. • Submit problem packs or appeals to specific payers. Ensure confirmation of receipt of claims. 5. Update accounts as necessary. Update accounts in GPMS with information obtained through correspondence and telephone (i.e; insurance, authorization, address, baby's name, etc.). Complete appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes are current and timely. 6. Identify carrier related denial trends. Review denial reports (GPMS Denial, NEIC, HBOC, Not Worked) for payer trends. Elevate problems to department Manager. 7. Exceeds required departmental productivity standards on a consistent basis. Average of quality and quantity productivity standards must meet or exceed 94%. 8. Maintain strict confidentiality - in accordance with HIPAA regulations and Company policy. Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment 9. Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties. 10. Performs other job-related duties within the job scope as requested by Management of Patient Accounts. 11. Embodies the principles of the corporate Mission Statement and Philosophy at all times. Represents the corporation in a positive fashion and makes all individuals feel as comfortable as possible and conducts all business in a professional manner - maintaining respect for individuals at all times. 12. Complies with departmental and company-wide policies and procedures. Maintains constant awareness of potential safety hazards insuring necessary safety precautions. Reads and complies with established policies and procedures. Qualifications Associate's degree (A. A.) or equivalent from two-year college or technical school; or two or more years related experience and/or training; or equivalent combination of education and experience. Must possess strong problem solving and decision making skills and be proficient in MS Excel and Word. Experience working in a physician/hospital billing or collection environment is required. MEDNAX IS AN Equal Opportunity Employer All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status MednaxCorp SDL2017
