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Employment Type:
Full time
Job Category:
Health Care Provider
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Home Care PFS Accounts Recievable Specialist - 14187
CHOP | Norristown, Pennsylvania
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Job Description

Job Summary

The primary focus of the accounts receivable specialist is to provide consistent follow up on the open account receivables for all Specialty Pharmacy therapies.  Responsible to review payments received for services rendered and to determine contractual compliance.  Responsible to provide payment disputes to third parties in a timely manner per payor, contractual and regulatory guidelines.  Work with manager and pre-cert coordinator to assure authorization issues are resolved and payment is received as expected.  Support manager by evaluating service line concerns and determining revenue margins for service line expansion.

Job Responsibilities

  • Review of the accounts receivable reports and explanation of benefits to determine outstanding balances for follow up.  Perform payment disputes timely and in accordance with payor, contractual and regulatory guidelines. Document all follow up activities into the patient’s medical record.
  • Review payments for accuracy. Identify and report all issues and identified trends related to contractual compliance utilizing the payor issue process to management.
  • Complete payor projects as assigned and document all follow up activity.
  • Perform as necessary, eligibility checks, payer changes, crediting and resubmission of claims.
  • Assist in obtaining/maintaining department’s cash goals.
  • Provide all home care patient financial services functions in accordance with CHOP, CHHC policy and all regulatory and accrediting agency guidelines.
  • Create monthly reports reflective of service line/therapy evaluation for concerns, expected revenue margin, and expansion.
  • Perform other duties as assigned by management.

Required Licenses, Certifications, Registrations


Required Education and Experience

Required Education: High School/GED

Preferred Education, Experience & Cert/Lic

Preferred Experience: Previous healthcare billing, accounts receivable experience.

Additional Technical Requirements

  • Strong organizational skills
  • Strong verbal, communications and organizational skills
  • Basic application and computer experience
  • Strong data entry skills.
  • Strong interpersonal and customer service skills. 

About CHOP

About The Children's Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents.

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