Accounts Resolution Specialist I - Ophth Clinical Support SEI

Penn Medicine • Philadelphia, PA • 20h ago

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Job Title: Accounts Resolution Specialist I

Department: Ophth Clinical Support SEI

Location: Penn Presbyterian Medical Center- 51 N 39th Street

Hours: Full Time

Summary:

The Account Resolution Specialist I reports to the Supervisor of Billing; primary responsibilities are to facilitate activities necessary to a successful resolution of accounts. This position will work out of assigned work queues handling claim edit work queue resolution as well as follow up work queue denials transferred from Professional Billing Office that require department intervention. Individuals will be responsible for investigating claim denials and underpayments by insurance carriers and appeal for payment or make appropriate adjustment. Exercising good judgement in escalating identified denial trends or root cause of denials to mitigate future denials, expedite the reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate a first pass resolution.

Responsibilities:

Responsible for patient account research in relation to working accounts within the claim edit work queue and follow-up work queue

Identifying untimely accounts and performing accurate and timely write offs adhering to policy guidelines

Responsible for maintaining the highest level of billing standards following current guidelines from Medicare, Medicaid, and other insurance entities.

Answering revenue cycle patient inquiries as well as front desk questions regarding patient accounts

Meets or exceeds established performance targets (productivity and quality) established by the Supervisor of Billing

Credentials:

Education or Equivalent Experience:

H.S. Diploma/GED (Required)

3+ years Working in health care (professional) billing, health insurance or equivalent

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

REQNUMBER: 301704

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