Patient Account Specialist - PFS Billing Services

This is a Full Time (80 hours every pay period) benefited position, Monday-Friday for day shift. Over time additional hours when needed.

Join the Scripps Health team and work alongside passionate caregivers and provide patient-centered healthcare. Receive endless appreciation while you build a rewarding career with one of the most respected healthcare organizations nationwide.

As a Patient Account Specialist, you will be supporting the Billing Services department at our 4S Ranch Business Services location. This role is essential in managing a high volume of hospital Government Insurance/Billing documents, while also performing follow up actions to gather accurate information needed from patients, payers and providers. The ideal candidate is one who thrives in a fast-paced environment and has a passion for insurance and medical claims.

As a Patient Account Specialist, you will be responsible for the following:

• Responsible for working aged reports and credit balances on a regular basis set by department guidelines.
• Follows-up with insurance carriers timely on unpaid claims until claims are paid or only self-pay balance remains. Does not have claims written off for timely filing.
• Processes rejections by either making accounts self-pay and generating a letter of rejection to patient or correct any billing error and resubmitting claims to insurance carriers.
• Keeps updated on all billing requirements and changes for all insurance types.
• Responsible for responding to all inquiries, billing denials, other correspondence and phone requests in an efficient, timely, and effective manner. Secures needed medical documentation required or requested by insurances.
• Works with HIM staff to ensure that complete diagnosis/procedure codes and modifiers are reported to insurance carriers as required.
• Working directly with the insurance company, healthcare provider, liable third parties, and patient to get a claim processed and paid.
• Works to help maintain Accounts Receivable (AR) days at or near target level set by the Hospital Senior Team.
• Supporting continuous improvement of organization processes and personal knowledge and skills, and maintaining and protecting confidential information.
• Providing excellent customer service through cooperative working relationships, and meeting productivity and quality standards.