PFS Pt Acct Denial Spclst - PFS Hospital - Home - FT/Days

Remote, USA

PFS Pt Acct Denial Spclst - PFS Hospital - Home - FT/Days

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it’s by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

 

Campus Overview

Kettering Health Main Campus

  • Kettering Health Main Campus, formerly Kettering Medical Center, is the flagship hospital of Kettering Health and has been serving Kettering, Ohio and the Greater Dayton area since 1964.
  • The facility includes the Benjamin and Marian Schuster Heart Hospital, maternity service with a level III neonatal intensive care unit (NICU), and level II Emergency Care.
  • In 2020, KH Main Campus received an “A” from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
  • Received 4 Star Baby-Friendly Hospital status by the Ohio Hospital Association.
  • Awarded as one of the 50 Top Cardiovascular Hospitals by IBM Watson Health in 2020.
  • Kettering received the Outstanding Patient Experience Award by Healthgrades (2017-2019).
  • Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
  • 465-bed hospital (includes newborn beds)

Responsibilities & Requirements

Responsibilities:

    • Under the direction of the Patient Accounts Manager or Patient Accounts Supervisor and guidance of the Team Lead the Patient Accounts Specialist is highly involved in all aspects of medical billing, and is responsible for escalated follow-up and denial work.
    • Participates in training and auditing of Patient Account Representatives.  
    • Works special projects as assigned. 
    • Effective in identifying and analyzing problems.
    • Generates alternatives and identifies possible solutions.
    •  Timely resolution of claim edits allowing timely claim submission
    •  Timely follow-up of unpaid claims, worked to ensure maximum reimbursement following compliant standards
    •  Ability to work independently as well as collaboratively within a team environment  
    •  Excellent problem-solving skills
    •  Creative ability to escalation of appeals
    •  Excellent verbal, written and customer service communication skills.

Preferred Qualifications