Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast.
Outstanding physicians, state-of-the-art facilities, innovative techniques and a commitment to serving the community enables Jupiter Medical Center to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS).
Education: High School Diploma or Equivalent.
Experience / Qualifications: 3+ years of experience in medical collections within a healthcare facility. Experience with Medicare, Medicaid, Managed Care contracts, other government payers, and commercial insurance plans. Ability to identify and calculate expected reimbursement from a UB-04, and provide clear written documentation to support logic applied. Familiarity with CPT and ICD-10 Codes, Procedural Modifiers, Claim Forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes. Demonstrates ability to retain knowledge and work independently in a fast-paced environment toward a designated goal. Detail-oriented and have ability to multitask in an efficient/effective manner with minimal supervision. Possesses knowledge of healthcare industry standards, good computer skills with proficiency in windows applications. Requires knowledge of standard office equipment (fax/copier, calculator, etc.). Ability to apply Mathematical and analytical skills. Excellent communication skills both verbally and in writing. Excellent interpersonal skills.
Applications utilized include Excel, Word, Star, Cerner, HPF, Experian products through Claim Source, Contract Manager, and Others.
Position Summary
Under the direct supervision of the Collections manager, the Patient Account Specialist- Hospital Collections would be responsible for the follow up of assigned accounts to obtain prompt payment or resolution in accordance with JMC Business Office policies and procedures. Provides expertise of explanation of benefits (EOBs), electronic payment Remittance (EPR), electronic funds transfer (EFT).
Denial management by investigating the reasons for denials, finding denial management strategies and when necessary appealing denials. Maintains daily follow up of assigned accounts to obtain prompt payment or resolution in accordance with the JMC Business Office policies and procedures. Maintains positive relationship with other hospital departments. Informs Collection Manager, and/or Managed Care of any contractual issues which might require heighten Managed care Director/Department intervention for resolution. Keeps Collection Manager informed of any potential negative financial impact on assigned accounts, including trending issues. Displays excellent customer service skills for both internal and external clients. Comfortable within a team working environment. Performs other duties as assigned.