Patient Financial Representative

Description

SIDNEY REGIONAL MEDICAL CENTER

Job Description:

Staff

JOB TITLE:

Patient Account Specialist

Exempt (Y/N): No Division: Finance Services

Department: Business Office Supervisor: Director Patient Financial Services

Prepare Date: 9/01 Revise Date: 10/3, 9/07, 7/13, 8/16, 10/23, 1/25

Serve as a patient account specialist, helping customers with questions regarding billing and insurance payments. Assisting customers with payment options and plans. Contacting patients to collect patient due balances. Prepare patients financially for services by providing estimates and payment options. Prepares and reviews accounts to be submitted to collection agencies. Processes estate, bankruptcy and small balance accounts. Follow up on all legal accounts.

Prepare and processes refunds. Ensures bad debt is returned and processed based on statute guidelines. Processes charity care application adjustments.

Is held accountable for following the policies and procedures of the department and organization. Additionally, the position serves as a role model for ethical behavior and promotes an awareness and understanding of positive ethical and moral principles consistent with the Mission, and Behavior Standards of SRMC. Employees are committed to being financial stewards of the organization by making ethical, efficient, and responsible financial decisions regarding organizational resources.

• Provide excellent customer service.
• Read, understand and research account balances to ensure they have been appropriately posted and the balances are patient responsibility prior to contacting patient with payment options.
• Contact customers to advise of payment options, on delinquent accounts to advise of additional options to bring accounts current and/or discuss full collection process.
• Assist patients with billing inquiries regarding statements, account charges, insurance payments and coverage and patient responsibility promptly, consistently and accurately.
• Consistently work tickler to process accounts according to tickler guidelines and rules, ensuring Collection Tickler is worked and current through the current week.
• Assure accounts are receiving statements, properly going through the aging process according to established guidelines and processes.
• Process and review financial applications, including charity and extended terms applications.
• Prepare patients financially for services by educating them of estimated cost of services and projected payment based on patients insurance policy and providing estimates and payment options prior to services.
• Post all payments collected and reconcile at end of day.
• Review, prepares and processes accounts to be submitted to collection agencies.
• Review that accounts have received the appropriate number of statements and phone call attempts before processing accounts to collections.
• Review that the account balance is patient responsibility.
• Review accounts for possible charity care prior to sending to collections.
• Research and respond to requests from collection agencies.
• Ensures bad debt is returned and processed based on statute guidelines.
• Review credits from the ATB report and consistently work credits on the collections tickler. Prepare and processes all refunds.
• Processes all estate, bankruptcy and small balance accounts.
• Process and follow up on all legal accounts.
• Assist accounting with the reconciliation of outstanding refunds checks.
• Remain current billing regulations and compliance issues.
• Identifying patient refunds and small balances for processing
• Sending legal notices in a timely manner, be informed on the legal aspects of Demand of notice, Statement of Claims.
• Obtaining correct insurance coverage from patients, adding coverage to accounts, collecting viable information and relaying to ICR team members.
• Assisting patients setting up calls between patient, payer and ICR team members.
• Posting payments to corporate accounts.
• Identify when duplicate guarantors exist, research creation, correct or send to department for correction.
• Employee is expected to be sufficiently knowledgeable about the legal aspects of his or her responsibilities and activities to be able to avoid inadvertent violation of State and Federal statutes and regulations & standards and refrain from knowingly participating in illegal activities or failing to meet affirmative legal duties. Employee shall report any suspected or known illegal activity.
• Regular attendance.

• Education:
  
  High school graduate or GED
• Experience:
  
  2-3 years of healthcare billing preferred.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Sitting – Continuous (67-100% of day)
• Standing - Occasionally…