SUMMARY OF DUTIES - Reviews alpha census daily and visits in-house patients; collects estimated patient liable amounts; works closely with outside agencies to ensure patient coverage.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
• Visit all self-paying patients in-house
• Provide estimates to patients and/or physicians as requested
• Generate insurance verification and precertification reports daily and follow up with case management and insurance verification departments as appropriate
• Post ER and Patient Access deposits into PA system
• Contact insurance companies for patient benefits and precertification requirements
• Review alpha census daily for visits exceeding original length of precertification and work closely with utilization review for concurrent certification
• Assist patients with payment arrangements and charity applications
• Work closely with outside agencies in helping patients apply for Medicaid and state aid
• Maintain insurance files regarding updates and changes
• Forward problems or concerns to Patient Access Manager
• Enter pertinent insurance information into CPCS and prorate account
• Enter notes into the collections system for all patient encounters
• Maintain professional image and implement excellent customer service to customers
• Complete financial analysis and collect estimated patient liabilities
• Follow up with patients for necessary signatures if they were incomplete at time of hospitalization
• Consistently receive and receipt payments from patients for hospital services in accordance with internal cash control procedures
• Interact with Patient Account Services Insurance Verification Department in establishing up-front payment arrangements with patients
• Attend in-service presentations and complete mandatory education week, including but not limited to, infection control, patient safety, quality improvements, MSDS and OSHA standards.
• Demonstrate knowledge of occurrence reporting system and utilize system to report potential patient safety issues.
• Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
• Other duties as assigned
• At least 1 year of collections experience required, preferably in a hospital or medical outpatient facility
• Relevant education may substitute experience requirement
KNOWLEDGE, SKILLS & ABILITIES
• Communication - communicates clearly and concisely, verbally and in writing
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
• Interpersonal skills - able to work effectively with other employees, patients and external parties
• PC skills - demonstrates proficiency in PC applications as required
• Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
• Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
• High school diploma or GED required
CERTIFICATE/LICENSE - N/A
PHYSICAL DEMANDS/WORKING CONDITIONS - Requires prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports. Requires lifting papers or boxes up to 25 pounds occasionally. Work is performed in an office environment. Work may be stressful at times. Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations.