Days / Hours:

- Monday - Friday; 8:00 AM to 5:00 PM

- No Holidays

- No Weekends

Job Title: Patient Account Specialist

Department: Business Office

Reports To: Business Office Manager

Position Summary: The Accounts Receivable (AR) Specialist is responsible for the accurate and timely posting and reconciliation of all insurance and patient payments, including daily deposits from remittances and patient transactions. This role supports cash flow and account accuracy by managing outstanding balances, following up on unpaid or underpaid claims, and assisting patients with account resolution. The AR Specialist also supports reporting and works collaboratively with revenue cycle teams to ensure efficient, accurate payment processing and account management.

Essential Job Functions Duties and Responsibilities

Payment Posting & Reconciliation

• Post daily insurance remittances (ERAs/EOBs) and patient payments (cash, check electronic) accurately and timely
• Balance and reconcile daily deposits to bank reports, clearinghouse files, and system totals
• Identify and resolve payment discrepancies, including denials, underpayments, and unapplied cash
• Ensure proper contractual adjustments are applied in accordance with payer agreements
• Maintain organized documentation of all payment activity for audit tracking purposes

Accounts Receivable Follow-Up & Collections

• Monitor and work AR Aging reports to ensure timely follow-up on outstanding balances
• Investigate and resolve unpaid or underpaid claims with insurance carriers
• Support billers with submitting corrections, rebills, or appeals as needed to secure appropriate reimbursement
• Escalate complex or high-dollar accounts for further review and resolution
• Support collection efforts by working with outside collection agency for patient balances and bad debt

Patient Account Support & Customer Service

• Respond to patient inquiries regarding balances, payments, and billing questions
• Assist patients with payment processing, including setting up payment plans when appropriate
• Educate patients on insurance coverage, billing processes, and financial responsibility
• Resolve patient account issues promptly and professionally to ensure a positive experience
• Work with others in business office to address registration or billing discrepancies impacting accounts

Reporting & Work Queue Management

• Run and review daily, weekly, and monthly AR and payment reports
• Maintain assigned work queues to ensure timely processing and follow-up of accounts
• Track and report trends related to denials, payment delays, and aging balances
• Prioritize workload to meet departmental goals and cash targets
• Support leadership with data gathering and reporting as needed

Revenue Cycle Collaboration & Process Improvement

• Collaborate with billing, coding, and registration teams to resolve account issues
• Identify trends or root causes impacting reimbursement and recommend solutions
• Assist in implementing process improvements to enhance efficiency and accuracy
• Ensure compliance with organizational policies, payer requirements, and regulatory guidelines
• Participate in team meetings and ongoing training to support revenue cycle performance

General Requirements:

Personal Responsibilities

• Works in harmony with assigned co-workers and other department staff.
• Is punctual in attendance. Adjusts personal schedule to work as scheduled. Provides proper notification for absence as per hospital policy.
• Accepts and responds to constructive criticism, assigned duties and suggestions in a cooperative manner.
• Demonstrates the ability to accept and implement change
• Completes assignments accurately and on time.
• Participates in continuing education programs and staff meetings as evidenced by attendance records.
• Where applicable, floats to other areas as assigned; responds to floating requested with a positive attitude.
• Willingly accepts assignments to special projects.
• Attentive to detail, record-keeping and required paperwork inherent to the position.
• Demonstrates kindness, courteousness, and sensitivity to patients, families, physicians, co-workers and visitors at all times.
• Appears well groomed and observes established dress guidelines, visibly wearing the name identification badge.
• Displays self-respect and pride in KCHS.

Customer Service

• Assists all patients, family members/significant others, physicians, visitors and employees in a friendly manner.
• Introduces self and uses caring, thoughtful words either in person or on the telephone.
• Demonstrates ethical and appropriate behavior for a healthcare environment to include, but not limited to, dignity, patient’s rights and privacy, and the maintenance of confidentiality of patient information.
• Demonstrates caring. If unable to assist an individual in needs, offers to find someone who can.
• Demonstrate proper telephone etiquette. If transferring a telephone call, announces the caller and briefly explains the situation before ending the transfer.
• Always makes eye contact when speaking with patients, family members/significant others, visitors, employees, etc. Knocks before entering a room or office. Addresses all individuals courteously.
• Keeps voice down, does not shout or use improper language. Responds to all inquiries promptly and courteously.
• Shares information so that the people who need to be aware of the facts are informed.

Infection Control

• Demonstrates adherence to infection control policies as evidenced by in-service attendance records and employee practices
• Demonstrates correct hand washing technique.
• Demonstrates knowledge of appropriate personal protective equipment (PPE) and uses same in practice.
• Notifies the Infection Control Nurse of real or potential exposures.

Risk Management & Safety Program

• Demonstrates adherence to risk management and safety policies and codes as evidenced by in-service attendance records and employee practices.
• Maintains a clean and safe environment for patient and co-workers.
• Follows all general safety rules.
• Notified the Safety Director and/or Risk Manager of incidents involving injury or having the potential for injury.
• Submits incident reports according to hospital policy.

Educational Responsibilities

• Completes required careLearning modules
• Attends mandatory Safety/NIMS in-services yearly
• Completes other required certifications or classes as necessary to perform the essential functions of the job

Qualifications:

Education and/or Experience:

• High school diploma or equivalent required; associate’s degree+ in business, healthcare admin, or related field preferred
• Minimum of 1-2 years of experience in accounts receivable, medical billing, or revenue cycle operations preferred
• Experience with payment posting, insurance remittances, and patient account management preferred
• Previous experience in a healthcare setting preferred

Certificates, Licensure, Registrations:

• No licensure required
• Certification in medical billing/coding or revenue cycle preferred but not required

Knowledge, Skills and Abilities:

• Strong understanding of healthcare revenue cycle processes, including insurance payments, adjustments, and AR follow-up
• High attention to detail with the ability to accurately post and reconcile payments
• Ability to analyze accounts, identify discrepancies, and resolve issues efficiently
• Strong organizational and time management skills with the ability to prioritize and manage multiple tasks
• Effective communication and customer service skills, particularly when working with patients and payers
• Proficiency with computer systems, including EMRs, clearinghouses, and Microsoft Office
• Ability to work independently while collaborating effectively within a team environment

Security/Access:

• Will have access to the facility while scheduled
• Will have access to confidential information abiding by the organization’s privacy policies and regulations concerning this information

Equipment, Tools, Materials:

• Computer, printer, fax, etc.
• Timekeeping system
• Information systems
• Telephone system
• General office materials/supplies