Patient Account Specialist Senior
TEEMA Group
About the role
Patient Account Specialist Senior
Role Summary
Take a senior-level seat in a high-performing medical collections unit where your expertise directly impacts the financial health of a premier healthcare system. As a Senior Patient Account Specialist, you will navigate the complexities of insurance reimbursement, identifying and resolving denied or underpaid claims with precision and speed. This role is perfect for a detail-oriented professional who enjoys solving financial puzzles and advocating for proper reimbursement through professional communication with payers, patients, and vendors. You will be a key contributor to maintaining the structural integrity of the accounts receivable process while ensuring world-class patient and client satisfaction.
Key Duties:
- Revenue Recovery: Collect outstanding balances from commercial, governmental, and third-party payers to ensure full and proper reimbursement for medical services.
- Claims Resolution: Proactively identify denied or underpaid claims, implementing timely solutions and appeals within specific payer guidelines.
- Knowledge Leadership: Maintain an expert-level understanding of payer claims processing, appeal procedures, provider contracts, and various payment methodologies.
- Technical Proficiency: Utilize a deep understanding of standard billing forms, filing requirements, and Explanation of Benefits (EOB) while navigating online payer portals.
- Trend Analysis: Identify and communicate recurring issues or industry trends that impact account resolution and overall reimbursement efficiency.
- Comprehensive Account Management: Manage both active Accounts Receivable (AR) and Bad Debt (BD) inventory, ensuring all documentation is accurate and compliant with state and federal guidelines.
- Stakeholder Collaboration: Facilitate professional communication with patients, clients, and reimbursement vendors to resolve complex account issues.
Required Qualifications
- Experience: Strong professional background as a medical collection specialist with a proven track record of resolving complex healthcare accounts.
- Skills: Expert knowledge of medical collection work processes and insurance reimbursement cycles.
- Compliance: Ability to adhere strictly to all client, state, and federal collection guidelines.
- Medical Requirements: Must complete all required medical screenings prior to start.
Desired Qualifications
- Communication: Exceptional interpersonal skills with the ability to manage conflict and provide a high level of patient and client satisfaction.
- Analytical Ability: Strong skills in identifying reimbursement trends and navigating various payer payment methodologies.
- System Knowledge: Familiarity with TLRA collection unit processes or similar large-scale hospital billing systems.
Location and Work Type
- Setting: Hospital Corporate Office / TLRA Collection Unit
- Work Type: On-site
- Location: Lake Charles, LA
- Schedule: Monday – Friday (8-hour shifts)
- Education Note: High School Diploma/GED verification is no longer required for this specific role.
If you're interested, please reply to this advertisement or directly email your resume to me at DSalgado@teemagroup.com or by calling/texting (949) 295-5951.
I strive to reply within 48 hours. Looking forward to connecting with you soon. Thank you!
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