Make your next big career move by applying as KMC Solutions’ next PATIENT ACCOUNT SPECIALIST!

Patient Account Specialists play a crucial role in ensuring an efficient RCM process at both the claim and patient levels. They manage patient accounts from Eligibility to charge submission all the way through tofinal resolution, working collaboratively to ensure the successful collection of all outstanding accounts receivable. This includes timely payment posting and successful appeals to expedite reimbursement.

On top of your salary, here are the exciting benefits you can look forward to:

Health Insurance/HMO
Enjoy unlimited MadMax Coffee
Diverse learning & growth opportunities
Accessible Cloud HR platform (Sprout)
Above standard leaves

The main responsibilities of a PATIENT ACCOUNT SPECIALIST include:

Scrub and submit daily charges to various payers.
Complete daily eligibility and benefit verification for all facilities utilizing best practice processes
Document financial and pre-certification information according to defined process in a timely manner.
Maintain and update patient demographic information and insurance details within the billing system.
Communicate with the front-end staff regarding patient deductibles, copays, and scheduling, ensuring accurate billing information is captured and communicated.
Locate remittances and payments in various portals.
Read and interpret Explanation of Benefits (EOBs).
Post payments manually or electronically (ERA), including patient and insurance payments, adjustments, and denials.
Transfer copay, coinsurance, and deductible balances to patient responsibility.
Review patient account balances to ensure posting accuracy as needed.
Perform payment and bank reconciliations.
Conduct daily cash reconciliation and reporting.
Research and resolve unapplied accounts.
Review EOBs to ensure appropriate steps are taken in resolving accounts; investigate, follow up with payers, and take appropriate action on insurance and legacy accounts assigned.
Ensure proper claim submission and payment through review and correction of claim edits, errors, and denials.
Solve practical problems and deal with various concrete variables in situations with limited information.
Effectively communicate via the CRM ticketing system with clients and internal staff members.
Submit requests to clients for medical records as needed.
Stay informed about current department policies and procedures.
Meet or exceed quality and quantity benchmark targets established by management (e.g., productivity, AR days, cash collections, bad debt, past-due follow-up).
Ensure the confidentiality of all patient accounts by following HIPAA guidelines.
Respond timely and accurately to all incoming correspondence and inquiries from insurance companies and other appropriate parties.
Post payments manually or electronically (ERA), including patient and insurance payments, adjustments, and denials.
Locate remittances and payments in various portals.
Transfer copay, coinsurance, and deductible balances to patient responsibility.
Review patient account balances to ensure posting accuracy as needed.
Perform payment and bank reconciliations
Conduct daily cash reconciliation and reporting.
Research and resolve unapplied accounts.

To apply, you must be an expert on the following requirements:

High school diploma or equivalent; college degree preferred.
Recent experience in vision care claim processing or a similar role in healthcare insurance is highly desirable.
Experience in Insurance Verification & Eligibility
Strong and current knowledge of vision care insurance policies, procedures, and clearinghouses.
Ability to do medical coding in ICD-10, CPT, HCPCS, and modifiers for professional fees.
Excellent organizational and time-management skills.
Exceptional communication and customer service skills.
Proficiency in using claim processing software and Microsoft Office Suite.
Attention to detail and ability to multitask effectively.
Ability to work independently and as part of a team.
Adheres to internal and system-wide competencies, behaviors, policies, and procedures to
Ensure efficient work processes

Make your next big career move by applying as KMC Solutions’ next PATIENT ACCOUNT SPECIALIST!

On top of your salary, here are the exciting benefits you can look forward to:

The main responsibilities of a PATIENT ACCOUNT SPECIALIST include:

To apply, you must be an expert on the following requirements:

It will also be favorable if you are knowledgeable in:

PATIENT ACCOUNT SPECIALIST

PATIENT ACCOUNT SPECIALIST

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