Patient Financial Services Rep - Call Center

Responsible for the collection and follow-up of all outstanding self pay and liability balances of ALMH and TMH Patient Accounts in accordance with policies and procedures, and determines customers’ eligibility for financial assistance programs. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values.

Education

Qualifications

• High School or GED equivalent required.
  
  

Experience

• One or more years of health care insurance and/or health care billing experience is required, preferably in the areas of billing, collections, or accounts receivable. Previous experience as a collector is highly desirable.
  
  

Other Knowledge/Skills/Abilities

• Experience with Microsoft Office products such as Word and Excel preferred.
• Basic working knowledge of personal computers required and their associate user software is preferred, with the ability to enter, retrieve, and electronically notate system screens.
• Familiarity with medical terminology, medical procedural (CPT) and diagnosis (ICD-9 & 10) coding and hospital billing claims form UB-04 highly preferred.
• Ability to multi-task while working on multiple responsibilities simultaneously.
• Ability to work successful with internal customers and external customers.
• Highly-developed critical thinking and problem solving-ability to work through complex situations.
• Knowledge of poverty guidelines, internal/external financial assistance programs and options, medical billing and insurance principles/practices.
• Demonstrates excellent oral and written communication, customer relations, and listening skills. Must demonstrate the ability to persuade and negotiate effectively.
  
  

Responsibilities

• Greets customers via telephone and determines nature of inquiry. Assists customers as necessary or refers them to internal or external sources.
• Reviews and prepares past due accounts for collection. Ensures appropriate collection code used for such accounts. Maintains appropriate information needed for Medicare Bad Debt.
• Assists patients with Financial Assistance applications and bank loans in a timely manner.
• Researches all sources of potential financial assistance based on the specifics of each application. This may include Medicare, Medicaid, Financial Assistance, bank loans, COBRA, etc.
• Requests and ensures the receipt of all pertinent information and supplemental documentation for the processing of financial assistance applications. Processes applications and monitors status to ensure an expedient decision involving each case, generating approval/denial letters.
• Responds to all mail inquiries or requests in a timely manner.
• Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values:
• SAFETY: Prevent Harm - I put safety first in everything I do. I take action to ensure the safety of others.
• COURTESY: Serve Others - I treat others with dignity and respect. I project a professional image and positive attitude.
• QUALITY: Improve Outcomes - I continually advance my knowledge, skills and performance. I work with others to achieve superior results.
• EFFICIENCY: Reduce Waste - I use time and resources wisely. I prevent defects and delays.
• Sets up and reviews terms accounts according to policy and procedure.
• Identifies self pay accounts at time of service, reviews for potential discounts and/or financial assistance and works with patient regarding payment options.
• Corresponds with collection agencies regarding payments and other situations with accounts including: review and report of bad debt payments, and review and approval of suit authorizations.
• Receives reviews and prepares accounts for bankruptcy purposes.
• Monitors estates and files appropriate paper work when needed.
• Reviews settlement offers and approves as appropriate.
• Researches and resolves complex issues associated with patient accounts. As applicable, identifies, documents, and reports problematic trends to leadership.
• Prepares and monitors monthly contract account.
• Reviews nursing home correspondence for potential care overlap and the appropriateness of billing Medicare vs. the nursing facility. Ensuring proper billing of those accounts.
• Identifies opportunities for account consolidation and takes the necessary steps to combine appropriate accounts.
• Processes and track all payroll deduct activity
• Processes credit card transaction payments on accounts.
• Performs other related work as required or requested.
  

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform tasks other than those specifically presented in this description.