Patient Accts Specialist - PFS NW Business Support - Miamisburg - FT/Days

Overview

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 Miamisburg  

• Serving the residents of Warren, Butler, and Southern Montgomery counties for over 40 years.
• Kettering Health Miamisburg, formerly Sycamore Medical Center, is a full-service hospital located minutes west of the Dayton Mall on Miamisburg-Centerville Road off I-75 in Miamisburg, Ohio.
• The cornerstone services for KH Miamisburg have been Bariatric surgeries and Orthopedic care. 
• Expanded services include emergency care, sleep center, mammography, breast MRI, cardiac catheterization lab, wound center and DEXA scanning. 
• 142 bed facility
• Awarded with 100 Top Hospital by IBM Watson Health for the 10th time in 2019.
• In 2020, KH Miamisburg received an “A” from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
• Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
• KH Miamisburg received several awards from Healthgrades:
  • Outstanding Patient Experience Award (2017-2019)
  • America’s 100 Best Hospitals for Prostate Surgery Award (2020)
  • Joint Replacement Excellence Award (2020)

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. 
• First level of contact for Patient Account Representatives. 
• Must display knowledge retention through scheduled assessments.
•  Must role model KHN Standards of Behavior. 
• Other duties as assigned. 
• This is not considered a leadership role in regard to authority over team members. 

Preferred Qualifications

Requirements:  

• Strong knowledge of payer guidelines including government payers
• Competent in preparing and submitting appeals for denied or delayed claims according to established protocols
• Competent in identifying and communicating recurrent insurance carrier denials to Team Lead
• Exceptionally well-versed in resolving errors to ensure prompt claim resolution
• Timely identification of delinquent accounts and following up to expedite resolution
• Expert in system (Epic) navigation     
• High School diploma or equivalent required
• Minimum of one years’ experience in patient billing required

Payer Reimbursement Policy/Contract understanding required

Overpayment experience required