Patient Accounts Specialist II - PFS Hospital

Job Details

PFS Hospital | Remote | Full-time | First Shift 

Responsibilities & Requirements

The Patient Accounts Specialist II supports patient care by ensuring accurate billing, timely collections, and effective resolution of patient account issues to optimize financial performance and maintain regulatory compliance. This role communicates with patients, payers, and internal teams to resolve billing inquiries, manage denials, and uphold confidentiality standards. Performs other duties as assigned. All job responsibilities are to be carried out in alignment with Kettering Health's mission, vision, values, and B Safe program.

Required Education

• High school diploma or GED 

Required Work Experience

• Minimum of 3 years of experience in patient accounting, medical billing, or healthcare revenue cycle operations 

Skills 

• Proficiency with healthcare billing and accounts receivable systems
• Knowledge of insurance claims processing and denial management
• Strong written and verbal communication skills 
• Ability to analyze and resolve account discrepancies
• Attention to detail and accuracy in data entry
• Understanding of HIPAA and patient confidentiality requirements 
• Ability to prioritize tasks and manage time effectively 
• Customer service orientation and problem-solving skills 

Essential Functions

• Submit and process insurance claims accurately and in accordance with payer requirements and organizational policies.
• Monitor and follow up on outstanding patient accounts to ensure timely collections and minimize accounts receivable.
• Communicate with patients to address billing inquiries, explain charges, and establish payment arrangements as needed.
• Analyze claim denials, identify root causes, and submit appeals or corrections to facilitate reimbursement.
•  Document all account activity, communications, and actions taken in the appropriate systems to ensure accurate records for audits and reporting.
• Collaborate with clinical, registration, and revenue cycle teams to resolve account discrepancies and support accurate billing.
• Ensure compliance with federal, state, and organizational regulations, including HIPAA and ACHC standards, in all billing and collection activities.
• Identify trends in denials or payment delays and recommend process improvements to reduce recurring issues.
•  Maintain up-to-date knowledge of payer policies, billing codes, and regulatory changes impacting patient accounts.
• Respond to requests for information from auditors, payers, or leadership in a timely and professional manner. 

Preferred Qualifications

• Associate's or Bachelor's degree in business, healthcare administration, or related field 
• Experience with electronic billing systems (such as Epic) and payer-specific billing requirements
• Certified Revenue Cycle Specialist (CRCS) through AAHAM or similar certification

Overview

Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.