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Department: Patient Financial Services
Status: Full Time
Shift: Days
Hours Per Shift: 8 Hour Shift
Job Details:
    • Job Objective: A brief overview of the position.
      • Works under the direction of the Patient Financial Service Manager. Is engaged in activities relating to the collection of payment and/or resolution of self-pay balance accounts.
    • Reports to
      • Patient Financial Service Manager
    • Supervises
      • None
    • Ages of Patients
      • None
    • Blood Borne Pathogens
      • Minimal/ No Potential
    • Qualifications
      • Education
        • Preferred: Some college preferred
      • Licensure/Certification
        • None
      • Experience
        • Required: One year prior experience in a hospital setting or billing certification; Experience in a clinic, payer or collection agency setting may be substituted. Must have working knowledge of managed care, Medicare/Medi-Cal Billing regulations. 
    • Essential Responsibilities
      • Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
      • Manages new accounts, on a daily basis, by working within Receivables Workstation. Interfaces with other departments within the hospital, when appropriate, to obtain information necessary to process or resolve claims. Contacts patient and/or account guarantor to solicit payment on account.
      • Works all accounts listed in the Follow-Up cue, on a daily basis to promote collection of accounts. This will include telephoning the payer or identifying the claim on the payers’ Internet websites.
      • Manages entire account inventory on a timely basis to promote payment and resolution of all accounts as instructed by management.
      • Responsible for staying current on all payer requirements by reading bulletins, reviewing provider handbooks, accessing websites, etc.
      • Process incoming correspondence, including signature letters, denials, prior authorizations and additional information necessary to process the claim.
      • Records newly identified insurance plans and facilitate the account processing of new plan in accordance with pre-billing policies and procedures.
      • Records accurate and definitive notes in the electronic account file that depict the current status of account, issues with account and anticipated date of resolution.
      • Escalates account management to Supervisor when extraordinary issues arise.
      • Assigns a status codes to each worked account to enable account tracking, statistical data gathering and audit activities.
      • Manages new credit balance accounts every day and prepares adjustments or refunds to zero the account balance.
      • Handle special projects as directed by management e.g. high dollar accounts, accounts over 180 days old, etc.
      • Performs other duties as assigned

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