Patient Accounts Coordinator

Overview

Job Summary

Patient Accounts Coordinator (PAC) works under the immediate supervision of supervisors/ managers in Patient Financial Services (PFS) performing tasks of moderate to difficult complexity relating to hospital or physician accounts. PAC is responsible for data analysis and interpretation throughout all functions of PFS, analysis of aged accounts including remittances to determine reasons for denials, non-payment and overpayment, post/ balance/ correct electronic remittances, billing and follow-up of government payers and specialized accounts, analysis/ correction of correct coding guidelines, preparation of accounts for appeal, review/ analysis of insurance credit balances and analysis/ movement of unapplied, unidentified, undistributed balances. Moderate to difficult levels of evaluation, analysis, decision making required in these roles.

Responsible for the reporting, monitoring, analysis, and follow-up of denials.  Identifies whether a denial can be appealed or if a write-off is required.  Provides appropriate denial information to root cause areas to ensure systems, processes and measures of effectiveness (e.g. remediation action plans) are created and implemented to reduce/eliminate denials

Essential Functions

• Completes claims and documents billing activity according to governmental regulations, agency policies and department guidelines.
• Reviews trends specific to denials, root cause, and A/R impact.
• Reviews insurance credit balances to determine root cause, takes necessary action to resolve account.
• Contacts payer and makes inquiries on account status.
• Processes and researches electronic remittances and bank deposits.
• Works with Specialty Payers and other facilities to ensure compliance and payment. Transfers charges between Patient and Facility accounts as required.
• Escalates problem accounts as needed and leads appeal process.
• Receives, review and takes actions for all communications within the business office.

   

Physical Requirements

 

Requires sitting for long periods of time. Requires bending and may need to lift-up to 10 pounds occasionally.

Education, Experience and Certifications

High school diploma or GED required. One-year experience in related financial services or healthcare business office required. College (bachelor’s or associate) degree preferred. Requires the ability to communicate effectively in verbal and written formats. Proficiency in Word, Excel and Outlook preferred. Prior healthcare computer system and specifically Epic billing experience preferred.