Position Summary
The Senior Financial Account Specialist is responsible for leading the teams in all billing and follow-up processes on a daily basis. Provides ongoing support to ensure all efficiency and productivity metrics are being met. The Senior Financial Account Specialist is responsible for all billing and follow-up processes for selected inpatient and outpatient claims, daily payment reconciliation, daily processing of refund applications and must also have the ability to use multiple systems.

Core Responsibilities
• Processes all billing both accurately and timely. Billing includes:
• Hard copy submission
• Electronically using Hospital Vendor software solution
• Secondary billing
• Late charges
• Adjustments
• Research and processes corrections for claims denying or suspending due to incorrect, incomplete, or missing information.(i.e. RTP file, Functional Acknowledgement (FA), remittances)
• Identifies contractual allowances that are not generated or generated incorrectly and allowance the account to the correct rate.
• Identifies and informs Supervisor of system issues (i.e. incorrect allowances, reports, bill form issues and revenue, CPT, ICD10 Coding)
• Identifies and informs Supervisor of input issues and provides examples. (i.e. policy ID#’s incorrect, insurance address or phone # not documented, incorrect primary verified.)
• Understands the UB04 bill form.
• Processes remittances/EOB’s both timely and accurately. Identifies payer or system issues and gives examples to Supervisor.
• Follows up on all aged accounts receivable. Follows the priority order established by the Supervisor.
• Rebills claims that are not in receipt of payer. Informs Supervisor of any non-receipt trends.
• Processes late charges when appropriate in accordance with the departmental procedures.
• Processes correspondence both timely and accurately. Informs Supervisor of payer trends.
• Process credit balances in priority order as established by Supervisor or departmental policy.
• Informs Supervisor of backlogs in a timely manner.
• Be knowledgeable of all PFS vendors and assist if needed on their reporting.
• Maintain a checklist of job responsibilities and actively review with teams tasks are completed.
• Works closely with Patient Financial Services Manager to ensure overall team and departmental success.

Minimum Requirements
• High School Degree or GED; or equivalent experience
• 5-8 years related work experience
• Knowledge of all hospital Information and Vendor Systems
• Working knowledge and understanding of PPS/DRG Billing policies, Managed Care Billing, Medical Terminology and CPT Billing
• Intermediate computer skills
• Excellent communication, organizational, and interpersonal skills
• Detail oriented

Preferred Requirements:
• Certified Patient Account Technician (CPAT)
• Certified Professional Coder (CPC)

Salary Range - $18.04 - $25.53 hourly

Additional information
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required.
• This job description should not be construed as an exhaustive statement of duties, responsibilities or requirements, but a general description of the job. Nothing contained herein restricts the company’s rights to assign or reassign duties and responsibilities to this job at any time.
• Shore Medical Center is an Equal Opportunity Employer. All applicants will receive consideration for employment without regard to sex, affectional or sexual orientation, gender, gender identity, orientation or expression; marital status, domestic partnership status, civil union status, pregnancy, race, creed, ancestry, color, ethnicity, national origin, age, disability, religion, genetic information, or veteran status or any other basis prohibited by law.