Patient Accounts Specialist - Blue Cross Team
MedStar Health
- Baltimore, MD
- Permanent
- Full-time
The BlueCross Team is responsible for AR follow-up for all CareFirst using the RCI tool for follow up. They are responsible for ensuring timely follow-up with CareFirst, submitting appeals as necessary and escalating accounts appropriately to ensure accounts do not age on the receivable. The team works closely with other internal PFS departments as well as directly with Provider Representatives at CareFirst to ensure timely resolution and payment.Job Description: Interprets and evaluates appeals to include follow-up with payers to assure timely turn around for claims resolution and reimbursement. Must be able interpret explanation of benefits and have a clear understanding of payer methodology. Works in a team environment.Primary Duties and Responsibilities
- Keeps abreast of regulatory and specific changes as it relates to billing requirements and payer specific follow up.
- Maintains daily performance benchmarks as it applies to interpreting and evaluating appeals to include follow up with payers. Completes coding report updates within the standard set in a timely manner to begin the daily workflow process. Responsible for reconciliation of reports to SMS and information that was posted.
- Maintains departmental QA standard within established error rate.
- Meets team specific benchmark as it applies to completed Tracking Forms forwarded to the Operational Desk after completion on a daily basis, >$10K, >$20K, AR15, AR30, and AR45.
Education
- High School Diploma or GED equivalent required
- 1-2 years experience in patient accounting, accounts receivable or related healthcare field required or
- An equivalent combination of experience and college education in accounting, finance or healthcare administration required
- Detailed working knowledge and demonstrated proficiency in at least one specific payers application billing and/or collection process.
- Requires basic working knowledge of UB04 and Explanation of Benefits (EOB).
- Requires some knowledge of medical terminology and CPT/ICD-9/10 coding.
- Excellent communication, analytical, interpersonal, and organizational skills.
- Proficient uses of hospital registration and/or billing systems and personal computers as well as Microsoft Excel and Word applications.
- Ability to type 35 WPM.
At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through:
- Strong emphasis on teamwork - our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
- Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
- Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
- More career opportunities closer to home - as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It’s how we treat people.MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.