Patient Accounts Specialist

Wage Range: $19.00/hour – $20.00/hour
(Actual wage based on relevant experience)

Position Summary

Responsible for processing claims of all third party payers and private pay patients, both inpatient and outpatient; handles correspondence to and from insurance companies regarding submitted claims; makes appropriate contacts, by telephone or correspondence, with patients or insureds regarding needed information to accurately bill patient’s claim; prepares EFT vouchers from third party payers for posting to patient accounts; must be available to the public, walk-ins and telephone calls, for any inquiries; monitor and manage accounts to minimize credit balances, bankruptcies, and self pay referrals to the extended business office.

Primary Responsibilities

1. Process all third-party payer claims.
2. Monitor the coding and charging of all outpatient visits, inpatient visits, surgical procedures, ancillary procedures and/or clinic procedures for appropriateness and reviews accounts for compliance with Federal and State billing requirements to payers.
3. Maintain the Epic claim edit, denial, rejection, follow-up, open remark and no response work ques for timely follow up for all payers and private pay.
4. Perform the necessary maintenance of patient accounts, i.e., correspondence, follow-ups, logs, inquires, payment arrangements, and correspondence to ensure accurate and timely communication with the extended business office.
5. Maintain a system to capture missed and/or late charges prior to submission of claims.
6. Accept and post payments via all payment methods from patients and third-party payers.
7. Prepare EFT vouchers for posting to appropriate accounts.
8. Balance receipts posted to the deposit slip to be sure all receipts tie out to close the day for posting.
9. Prepare and maintain the Bad Debt Collection files and work closely with that agency.
10. Maintain the patient accounts for bankruptcy claims and take appropriate measures to remain within required Federal guidelines.
11. Reconcile credit balances on patient accounts according to the guidelines within the Financial and Collection Policy.
12. Reconcile and submit the quarterly credit balance report to Medicare and Medicaid.
13. Work with other departments to ensure best practices and processes for the entire Revenue Cycle.
14. Work closely with healthcare providers in the education of billing and coding principals.
15. Maintain knowledge of Federal and State billing requirements.
16. Maintain proper telephone etiquette.
17. Perform other duties as assigned and requested.

Required Qualifications

High School diploma and/or GED equivalent.

Knowledge of medical terminology.

3-5 years of hospital or clinic billing experience in CAH, RHC or FFS.

Experience with claim processing and denial follow up.

Experience with Microsoft Word, Excel and Outlook.

Preferred Qualifications

Certified Critical Access Biller/Coder, CRCS, CRCP or work equivalence.

Physical and Environmental Demands

Frequently: Prolonged periods of sitting or standing.

Frequently: Prolonged exposure to computer screens.

Location: Carthage, IL (possibility of remote work in future)

Status: Full Time (approx 40 hours per week)

Screening of Applications Begins: December 23, 2025

Open:Until filled

Wage Range: $19.00/hour – $20.00/hour
(Actual wage based on relevant experience)