Account Resolution Specialist - Self Pay Operations - FT 1.0 (80 hrs biweekly) bei MEMORIAL HEALTH SYSTEM

Description

In a culture of continuous quality improvement and a commitment to delivering a positive billing experience, the Account Resolution Specialist serves as a subject matter expert and liaison. This role is responsible for verifying the accuracy of insurance registration, payment, and adjustment postings, and the effectiveness of the self-pay collection process on behalf of the patient. The specialist evaluates and analyzes data to identify trends and opportunities for process improvement. They consistently demonstrate the Standards of Excellence and always uphold strict confidentiality.

Job Functions:

1. Conduct comprehensive reviews of patient accounts with self-pay balances to identify issues such as payment delays, posting inaccuracies, untimely insurance submissions, and missed discount applications (e.g., uninsured, prompt pay, charity care).
2. Leverage eligibility coverage discovery tools to identify third-party coverage for patients registered as uninsured.
3. Utilize propensity-to-pay tools to assess potential eligibility for Medicaid or Financial Assistance programs.
4. Collaborate cross-functionally with Patient Access, Patient Financial Services, Coding, Financial Advocates, and Medicaid Eligibility vendors to ensure accurate and timely billing.
5. Proactively contact patients to obtain necessary documentation or information required by third-party payers to resolve denied claims (e.g., COB, accident details, PR227).
6. Identify recurring trends or patterns to develop strategies aimed at preventing future billing issues.
7. Communicate directly with patients via phone, email, or mail to resolve outstanding account balances.
8. Educate and assist patients regarding billing disputes, financial assistance programs, payment plans, available discounts, and HELP Financial contract setup.
9. Assumes all other duties as assigned.

Qualifications

Minimum Education/Experience Required:

• High school diploma or GED required.
• A bachelor’s degree in healthcare administration, business, or a related field is preferred.
• Minimum of two years of relevant experience required.
• Experience in healthcare billing or related fields, knowledge of health insurance processes, policies, and procedures preferred.

Special Knowledge, Skills, Training:

• Strong negotiation and communication skills, with the ability to advocate effectively on behalf of patients.
• Excellent attention to detail and analytical skills to review and interpret complex insurance policies and claims.
• Ability to work independently and collaboratively in a fast-paced, deadline-driven environment.
• Proficient in using computer systems and software applications related to claims processing and documentation.
• Strong problem-solving skills; strong computer skills; fluent in Excel and PowerPoint; manual dexterity, color vision, and near visual acuity.

Compensation Details:  Education, experience, and tenure may be considered along with internal equity when job offers are extended.
 

Benefits:  Memorial Health System is proud to offer an affordable, comprehensive benefit package to all full time and flex time employees.  To learn more about the many benefits we offer, please visit our website at www.mhsystem.org/benefits.

Bonus Eligibility:  Available to qualifying full or flex time employees. Eligibility will be determined upon offer.

Memorial Health System is an equal opportunity provider and employer.

If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at https://www.ocio.usda.gov/document/ad-3027, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Stop 9410, Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at [email protected].

* Memorial Health System is a federal drug-free workplace.  This policy prohibits marijuana use by employees.