Patient Account Specialist - Palliative Care presso Lower Cape Fear LifeCare

Position Title: PAC-001:  Patient Account Specialist - Palliative Care

Status: Non-exempt, Non- management

Reports to: Director of Patient Financial Services

Department: Corporate Services

Job Summary: 

The Patient Account Specialist is responsible and accountable for the preparation, submission, and verification of patient claims.  This position is responsible for monitoring and following up on delinquent patient accounts, for auditing patient files for accuracy, and for ensuring that accounts receivable and accounts payable information corresponds with claims filed.  The Insurance Claims Representative maintains contact with internal and external personnel to ensure accuracy and timeliness of patient accounts and performs other duties as assigned.

Primary Job Duties:

 1. Prepares and transmits insurance claims utilizing patient files as documentation for the reimbursement of the health care given to LCFLC patients.

  2.    Ensure patient financial information is entered correctly in Netsmart.  Audits patient files on a monthly basis to ensure that payers have been billed for all patients served during the month.

  3.    Monitors remittance advices from payers for accuracy and patient accounts receivable records.  Takes appropriate action for outstanding balances for accounts. 

  4.    

  5.    Interacts with external and internal personnel to ensure that the documentation used for billing is accurate, complete and available.

  6.    Organizes and performs work effectively and efficiently.

  7.    Maintains and adjusts schedule to enhance program performance.

  8.    Demonstrates positive interpersonal relations in dealing with all members of the team.

  9.    Maintains and promotes customer satisfaction.

10.    Effectively demonstrates the mission, vision, and values of Lower Cape Fear LifeCare on a daily basis.             

Job Specifications:     

  1.        Education: High School Diploma or GED required.  Prefer Associate’s Degree or equivalent combination of education and experience.

  2.      Licensure / Certifications:  None

  3.      Experience: Minimum of one year related experience required.  Prefer two years of related experience.

  4.      Essential Technical / Motor Skills: Microsoft Excel experience required.  Microsoft Word a plus.   Ability to calculate discounts, percentages, and changes in rates using basic mathematics and algebra.

  5.      Interpersonal Skills: Ability to effectively communicate with internal and external personnel.

  6.      Essential Physical Requirements:  Long periods of sitting or standing, walking, lifting and carrying files and supplies, reaching, stooping, long periods of data entry/file updates.

  7.      Essential Mental Abilities: Ability to work independently and to handle the stress of regular deadlines.  Ability to organize and prioritize work.  Ability to understand and comply with rules and regulations            related to Medicare.

  8.      Essential Sensory Requirements: Visual acuity, touch, and hearing.

  9.      Exposure to Hazards: Normal office environment.

10.      Other - Hours of Work: 40 hours per week.  Overtime or flexible hours may be required during peak billing times.

11.      Population Served: External and internal personnel.