Patient Account Specialist Resume Sample
Janie Willms
11861 Mertz Lock,
Phoenix,
AZ
+1 (555) 589 4524
Work Experience
Patient Account Specialist
10/2017
-
PRESENT
Philadelphia, PA
- Adheres to and participates in Company’s mandatory HIPAA privacy program / practices and Business Ethics and Compliance programs / practices
- Responsible for analyzing department needs and suggesting ways to improve future cash flow
- Help identify changes in policy and procedures to improve office efficiencies and communicate to
- Two years’ experience with healthcare claims
- Utilize proper response letters on computer for various incoming correspondence. =
- Answers calls, voice mail and correspondence within department standards for account resolution
- Follow up of unpaid accounts, review denied claims, unpaid claims and account balances. Enter or update notes on accounts as they are worked
Frx-patient Account Specialist
02/2011
-
09/2017
Chicago, IL
- Reviews and determines accuracy of demographics, insurance and billing data and updates as need to ensure proper and timely collections of accounts. Enter or update notes on accounts as they are worked
- Work with insurance companies to resolve payment of claims via telephone, bring current or collect past due accounts, referring unusual account situations to higher management
- Determine and take appropriate action for delinquency and non-payment of accounts
- Uphold highest level of customer service, ability to a handle large volume of accounts, be a team player, a self-starter and have a strong work ethic, Works well independently as well as part of a team
- Maintain and organize patient file documentation
- Maintains knowledge of contracts, reviews billing and cash collected to ensure correct reimbursement
- The ability to maintain friendly, cordial relations with all clients and employees
Satellite Patient Account Specialist
04/2005
-
10/2010
Chicago, IL
- The ability to maintain friendly, cordial relations with all clients and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers
- Comply with ATI standards of operations
- Adhere to the Core Values of the Company
- Utilize proper response letters on computer for various incoming correspondence
- Experience: 1 year of patient accounting experience
- Skills & Abilities: Excellent data entry skills; good telephone communication skills, good persuasion skills; ability to independently follow office procedures and job instructions and use good judgment in determining when assistance is needed; basic understanding of insurance and medical terminology
- Performs reconciliation of refund accounts; attached documentation and forwards to supervisor to process refund checks
Education
Oregon State University
1999 - 2004
Bachelor's Degree in Progress
Professional Skills
- Excellent interpersonal skills to effectively interface with internal and external clients and customers at all levels
- Utilize strong organizational skills with an ability to effectively manage large amounts of detailed information
- Multitask and stay organized. Good verbal and written communication skills. Detail oriented and ability to prioritize work
- Professional appearance, excellent verbal communication and time management skills is a requirement
- Strong phone and computer skills with working knowledge of practice based medical office processes and procedures as well as billing processes and procedures
- Possess superior problem solving and analytical skills and have a strong ability to work on several tasks simultaneously
- Demonstrate a strong knowledge of third party payers including Medicare, Medicaid and local HMO/PPO’s
How to write Patient Account Specialist Resume
Patient Account Specialist role is responsible for insurance, basic, analytic, microsoft, computer, medical, organization, analytical, research, retail.
To write great resume for patient account specialist job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Patient Account Specialist Resume
The section contact information is important in your patient account specialist resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Patient Account Specialist Resume
The section work experience is an essential part of your patient account specialist resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous patient account specialist responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular patient account specialist position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Patient Account Specialist resume experience can include:
- Assign accounts to outside collection agencies for further action. Knows and adheres to policies of the Center and demonstrates fiscal responsibility
- Validate insurance copays for dispensed prescribed medications are billed correctly
- 2 Review payment vouchers, claim rejections and insurance correspondence to determine the validity of
- Organize and prioritize work as required
- Working for a FORTUNE 200 company stability-as the nation's largest independent provider of dialysis services
- Knowledge of government and non-government uniform billing guidelines (Medicare Billing Specialist and State Fair Hearing/Advanced Billing Specialist only)
Education on a Patient Account Specialist Resume
Make sure to make education a priority on your patient account specialist resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your patient account specialist experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Patient Account Specialist Resume
When listing skills on your patient account specialist resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical patient account specialist skills:
- Effectively present information and respond to inquiries or complaints from payers, patients and/or their representatives
- Skills in critical thinking based on the review of credits applied to the patients accounts (Refund Specialist only)
- 8 Demonstrates understanding of prevailing regulatory or third party requirements regarding authorization
- Work with large amounts of data, including checks for integrity, summation, and effective communication to internal and external constituents
- Verify insurance for each appointment prior to patient arrival, notifying patient of any payment due from patient
- Monitor and provide as needed, to staff 2 days prior to scheduled visit, patients’ outstanding balance
List of Typical Experience For a Patient Account Specialist Resume
1
Experience For Frx-patient Account Specialist Resume
- Processes insurance/patient correspondence, including denial follow-up within 48 hours of receipt. - Files all reimbursement correspondence daily
- Accountable for seeking necessary resources to ensure timely follow-up and resolution of unresolved issues
- Follows standards, policies, procedures, goals, and objectives for business office according to accepted standards
- Performs inpatient/outpatient billing process
- Resolves inpatient/outpatient accounts by securing payment or denial by a third party payer
- Research and resolve billing questions from customer calls and correspondence
- Educate patients and establish payment arrangements to resolve outstanding balances
- Complete special assignments involving patient account support, research and resolution
2
Experience For Senior Patient Account Specialist Resume
- Process hearing aid returns as needed
- Complete daily charge entries in the billing software system
- Receives and resolves patient billing complaints and questions. Reviews credit balance reports for correct recipient of refund
- Processes insurance/patient correspondence, including denial follow-up within 48 hours of receipt
- Maintains confidentiality regarding patient account status and the financial affairs of the clinic/corporation
- Resubmits insurance claims within 72 hours of receipt. Participates in maintaining Payor Manuals/Profiles
- Identified problems on accounts and follows through to conclusion
3
Experience For Satellite Patient Account Specialist Resume
- Resolve and document customer service/patient inquiries on the first call
- Research, trouble shoot with others to resolve complex issues and patient complaints
- Evaluate and respond to all aspects of written or received patient correspondence
- Request patient payments and process credit card payments as necessary
- Researches/documents all requests for refund and contract issues
- Manages assigned accounts receivable inventory
- Request adjustments to accounts when applicable
4
Experience For Medicare Patient Account Specialist Resume
- Document patient feedback, call summary, and resolution in system note file
- Post EOB and payments to patient’s account; process refunds to patients and/or insurance companies as needed
- Actively work with insurance companies to insure compliance with established fee schedules, contractual provisions, and verify duplicate payments
- Maintain fee schedules for all insurance carriers and third party payers
- Contact patients to discuss payment options and payment agreements as needed
- Serve as liaison with third party biller
- Provides effective collection services, ensuring the successful recovery of accounts in accordance with client and state guidelines and TLRA's business objectives
- Handles inbound patient account calls promptly and professionally, providing assistance and resolution to account inquiries, issues, and requests
5
Experience For Patient Account Specialist Resume
- Documents and updates patient account information in TLRA's collection software system timely and accurately
- Reviews account information for appropriate status in TLRA's collection system
- Makes an accurate decision when identifying non-self pay accounts by transferring accounts to appropriate work unit and documenting account information in the collection system
- Identify training opportunities and provide feedback to leadership and teammates on training opportunities
- Answers all incoming patient calls to Billing Department
- Works with provided aging to monitor patient account aging and follows up appropriately
6
Experience For Frx-patient Account Specialist Resume
- Register patients in the Emergency Room, outpatient services, and admitting
- Reviews account aging on a monthly basis and reports inconsistencies; corrects errors as appropriate
- Review and approve Medicare bad debt adjustment logs; audit Medicare bad debts write-off requests to ensure reviews are complete before writing off bad debts
- Work with Revenue Operations and department teammates as necessary Attend team meetings, phone conferences, and training as needed
- Review, audit and approve Medicare bad debts write-off requests to ensure process-alignment, proper claims accounting and compliance protocols
- Prepare daily and monthly metric reporting on key performance indicators for assigned book of business
- Stay up to date on communication relating to Medicare, CMS and Medicaid program updates
- Investigates and answers billing inquiries related but not limited to co-payments, deductibles and co-insurances
- Answers billing inquiries from Attorney Offices
7
Experience For Senior Patient Account Specialist Resume
- Maintains patient privacy by keeping all patient information confidential
- Knowledge of handling patient accounts
- Reviews account aging on a monthly basis
- Performs research and analysis of account issues, and strives to resolve problems timely and accurately
- Performs other special projects as required as assigned
- Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regard to patient records
- Prepare monthly audit result reports
8
Experience For Satellite Patient Account Specialist Resume
- Key and balance Medicare Bad Debt adjustments
- Prepare daily and monthly Medicare Bad Debt team reports
- Report monthly statistics on Patient Financial Evaluation transactions
- Know, understand, and follow teammate guidelines, employment policies, safety and security policies, and department or company procedures
- Reviews all patient phone messages and triages to appropriate area as needed for escalation
- Collects payments from patients over the phone and processes them via the credit card terminal
- Obtains accurate, pertinent patient and insurance demographic information and updates in computer system as necessary
9
Experience For Medicare Patient Account Specialist Resume
- Performs automated functions that fall within job responsibility
- Maintains confidentiality in regard to patient account status and the financial affairs of clinic/corporation
- Reviews EOBs to ensure proper reimbursement of claims
- Reviews account agings on a monthly basis and reports inconsistencies and corrects errors as appropriate
- Follows up on insurance billing to ensure timely receipt of payments. Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances
- Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments. Reviews credit balance reports for correct recipient of refund
- Works with provided aging to monitor patient account agings and follows up appropriately. Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation
- Bill, upload and correct claims in clearinghouse
- Status unpaid claims and patient accounts
10
Experience For Patient Account Specialist Resume
- Balance and complete daily deposit
- Deeply built values of TEAM
- PATIENT ACCOUNT SPECIALIST
- Versed in CPT/ICD-10 codes
- Possesses up to date knowledge of the profession and industry
- Accesses and uses resources when appropriate
- Shows resilience in the face of constraints, frustrations, or adversity
List of Typical Skills For a Patient Account Specialist Resume
1
Skills For Frx-patient Account Specialist Resume
- Excellent skills using Microsoft Office products including Outlook, Word, and Excel
- Strong skills in the use of computer applications and systems including:Excel, Word, Internet, email, and miscellaneous programs and networked computer systems
- Detail oriented and ability to prioritize work. Requires a moderate level of interpersonal, problem solving, and analytic skills
- Detail oriented and ability to prioritize work. Requires a moderate level of interpersonal, problem solving, and analytical skills
- Multitask/stay organized. Good verbal and written communication skills
- Multitask and stay organized. Good verbal and written communication skills
- Intermediate computer skills and proficiency in Microsoft Office suite required
- Multitask/stay organized. Good verbal and written communication skill
- One or more years’ experience in a patient accounts or business office setting for a hospital, physician's office, or other medical setting
2
Skills For Senior Patient Account Specialist Resume
- Is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change
- Health care billing work experience
- Medical billing, account receivable follow-up experience required
- One year experience as an office assistant in a hospital, physician office, or other medical setting
- Strong working knowledge of managed care plans, insurance carriers, government Payers and payer requirements
- Two (2) years experience in customer service, collections, or related field
3
Skills For Satellite Patient Account Specialist Resume
- Demonstrate compliance with all state and federal regulations for managed care and third party payers (Third-Party Billing and Collections only)
- Medical accounts receivable experience
- Account services experience required
- Uses Technical and Functional Experience
- Two years of patient accounts experience in a healthcare setting
- At least one year of health care billing work experience
- Detail oriented and ability to prioritize work
- Scanning and saving work
- Passing the Driver's License Check and/or Credit Check (for those positions requiring)
4
Skills For Medicare Patient Account Specialist Resume
- Complete Payment Audits while monitoring/documenting the aging on a monthly basis
- Knowledge of medical insurance practices and policies and regulations (Medicare Billing Specialist and State Fair Hearing/Advanced Billing Specialist only)
- Generates bills for charges by downloading, entering and adjusting data
- Maintains a working relationship with payment poster, billing and scheduling to ensure proper payment
- Provide on-going detailed assessments of insurance payer trends, providing solutions for credentialing, rejected and denied claims
- Coordinate with third party billing staff to insure accurate patient billing, collections, and reporting
- Knowledge of HMO, PPO, and Indemnity third party billing guidelines (Third-Party Billing and Collections only)
5
Skills For Patient Account Specialist Resume
- Knowledge of either UB04 hospital or CMS physician billing forms (Third-Party Billing and Collections only)
- Knowledge of government and non-government uniform billing guidelines (Third Party Billing only)
- Request authorizations for patients who have been approved for funding or new incoming patients
- Basic knowledge of hospital terminology applicable to patient billing
- Provide training and comply on Company standards of operations
- Correspond with Insurance companies to communicate billing, payment, and to recapture unpaid balances
- Provides assistance and information to co-workers and patients regarding patient information, insurance claim status, and patient self-pay responsibilities
- Bi-lingual - Spanish speaking
- In a healthcare setting
6
Skills For Frx-patient Account Specialist Resume
- Medical practice in Suffolk County looking for a Patient Account Specialist to join their team
- Assists patient with financial options when needed including referral for financial assistance, long term payment plan, etc
- Familiarity with Medical Insurance
- Understand clinical/medical vocabulary most commonly written or spoken
- Outbound calls to patience to resolve payment
- Review credit balances for client accuracy
- Reviews appropriate files to identify deceased; communicate to estate and court
- Reviews EOB's to report payor trends
7
Skills For Senior Patient Account Specialist Resume
- Prepares write - off requests with appropriate documentation
- Maintains confidentiality in regards of patient account status
- Occupational Exposure: Category C - No partners in the specified job classification have occupational exposure
- Knowledge of medical terminology and coding Related to hospital billing and/or professional billing such as revenue, CPT diagnosis codes, modifiers, occurrence codes, value codes, and the appropriate usage of these codes
- Demonstrate familiarity of the components of a medical chart in order to supply appropriate chart documentation to various payers as required (Third Party Billing and Collections only)
- Identify any trends related to their assigned payer in order to escalate to management or provider representative (Third-Party Billing and Collection only)
- Strong analytical and critical thinking abilities in order to make sound decisions
- Read and interpret payer explanations of benefit documents (Third-Party Billing and Collections only)
8
Skills For Satellite Patient Account Specialist Resume
- Strong working knowledge of medical terminology and coding related to hospital billing and/or professional billing such as revenue codes, CPT codes, diagnosis codes, modifiers, occurrence codes, and value codes and the appropriate use
- Skill in evaluating bills/claims with an understanding of the types of facilities patients are coming from and/or going to for accurate billing in order to collect payment in a timely manner
- Ensures established quality standards are met and proper documentation regarding patient accounting records
- Contacts other departments to obtain necessary information for appeals, pending informaton and any other issues that impact and/or delay claim processing
- Possesses and maintains knowledge of current Medicare/CMS regulatory and third party payer requirements to support billing reimbursement
- Keeps self-up to date on local coverage and national coverage determinations (Medicare Billing Specialist only)
- Keeps self-up to date on any up and coming Medicare changes or updates by dialing into monthly/ quarterly ask the contractor and other Medicare forums as well as information on changes available on the Medicare website (Medicare Billing Specialist only)
- Possesses a clear understanding of and ability to work directly with the nurse auditor on ADR’s, Suspense claims, T status claims, Probes, Cert’s, and Appeal processes (Medicare Billing Specialist and State Fair Hearing/Advanced Billing Specialist only)
9
Skills For Medicare Patient Account Specialist Resume
- Knowledge of the Medicare credit balance analysis and reporting (Medicare Billing Specialist only)
- Prepares disputes, redeterminations and reconsiderations for Medicare denied claims in conjunction with nurse auditor (Medicare Billing Specialist only)
- Exceptional communication skills, with the ability to write correspondence and effectively present information in one-on-one and small groups situations to customers, clients, and other employees of the organization
- Strong analytical skills in order to take appropriate action on Medicare claims, reports, spreadsheets and correspondence (Medicare Billing Specialist only)
- Effectively present information and respond to inquiries or complaints from payers, patients and/or their representatives, and the general public
10
Skills For Patient Account Specialist Resume
- Validates claim payments to ensure claims are paid according to contract and/or payment methodology guidelines
- Initiate Medicare Redetermination, Reopening, and/or Reconsideration as needed
- Serves as the primary collector for all types of insurance, including Medicare, Medicaid, Champus, HIS, Holds, Rule 25, Blue Cross Blue Shield, Medica
- Maintains actvie knowledge of all collection requirements by payors
- Collects balance owing from third party payers in accordance with State and Federal laws governing collections practices. Ensures that colletion efforts are thorough with overall objective being to collect outstanding balances in an eithical manner
- Provides effective and timely collection services ensuring the successful recovery of accounts in accordance with client and state guidelines as well as TLRA's business objectives
- Correct claims in RTP status in either CCSM or DDe per Medicare guidelines
- 4 Processes change of addresses, financial class code and other responsible party information as deemed
List of Typical Responsibilities For a Patient Account Specialist Resume
1
Responsibilities For Frx-patient Account Specialist Resume
- Basic computer skills, including the Microsoft Office Suite
- Handle multiple priorities concurrently with shifting time frames to meet deadlines
- Patient accounts experience in a healthcare setting
- Basic reading, writing and arithmetic
- Establish/maintain cooperative working relationship with staff, Medical Staff and providers
- Basic understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPC Codes
- Basic understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPCS Codes
- Handles patient accounts and updates as needed including demographic updates, adjustments, cash transfers, charge corrections, etc
- Knowledge of radiation therapy
2
Responsibilities For Senior Patient Account Specialist Resume
- Keep neat, accurate records
- Follow direction from the office coordinator and manager
- Knowledge of: Medical Terminology and Medicare Compliance - HIPAA privacy requirements for patient information - DRG's, Medical ICD9/ICD10 codes and CPT/HCPC Codes - Insurance and reimbursement process
- Knowledge of Medical Terminology and Medicare Compliance. Familiarity with HIPAA privacy requirements for patient information
- Detail oriented and ability to prioritize work. Requires a moderate level of interpersonal, problem solving, and analytic skills. Knowledgeable on insurance and reimbursement process
- Establish/maintain cooperative working relationships with staff, Medical Staff and providers
- Knowledge of Medical Terminology and Medicare Compliance
3
Responsibilities For Satellite Patient Account Specialist Resume
- Familiarity with HIPAA privacy requirements for patient information. Basic understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPC Codes. Ability to multitask and stay organized
- Good verbal and written communication skills. Detail oriented and ability to prioritize work. Requires a moderate level of interpersonal, problem solving, and analytic skills
- Knowledgeable on insurance and reimbursement process
- Familiarity with HIPAA privacy requirements for patient information
- Knowledge of Medical Terminology and Medicare Compliance. Familiarity with HIPAA privacy requirements for patient information. Basic understanding of DRG's, Medical ICD9/ICD10 codes and CPT/HCPC Codes
- Works with inbound phone calls in a professional manner
- Analyzes and collects unpaid self-pay balances to ensure accounts are paid in full
4
Responsibilities For Medicare Patient Account Specialist Resume
- Documents discussions with patients or parties by entering detailed notes in the appropriate software, and ensures accurate record keeping for any follow up needed
- Time management and ability to work independently
- Proactively communicate and respond promptly to identified issues
- Knowledge and utilization of desktop applications to include Word and Excel is essential
- Initiate and follow through on projects and work independently with minimal supervision
- Uses, protects, and discloses patients’ protected health information (PHI)only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Two (2) years of patient accounts experience in a healthcare setting
5
Responsibilities For Patient Account Specialist Resume
- Healthcare experience required
- CPAR-Certified Patient Account Representative (HFMA Georgia)
- Performs follow-up on all submitted claims for reimbursement. Follows up with insurance company or third party payer to ensure correct and timely processing of claims and proper payment of claims
- Coordinates third party denial information, works denials through appeals process. Documents in AR patient account notes
- Track team productivity
- Batch Insurance Refunds
- Batch Personal Refunds
- Post payments daily
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