Title: Patient Financial Specialist
FTE: 1.0 FTE (40 hours/week)
Schedule: Monday – Friday from 8:00am – 4:30pm
Holiday Rotation: N/A
Weekend Rotation: N/A
This position works closely with patients as a resource for account questions. Responsible for all financial interactions with patients who present at the Patient Service Center, including self-pay account collection and follow-up, payment plans, processing community care applications, monitoring collection activities, and registering any patients who are not preregistered. This position is responsible for keeping abreast of statutes and legal regulations that could affect collection of receivables. Personal interactions must balance the financial requirements of the organization with compassion for individual circumstances, while promoting a positive image of the organization.
POSITION TECHNICAL RESPONSIBILITIES:
Account Collection and Follow Up
- Greet all patients. Verify demographic and insurance information.
- Identify accounts for financial counseling.
- Obtain consents.
- Secure an equitable payment plan according to preset guidelines when patient is unable to make payment in full while maintaining good patient relations.
- Follow up on all assigned accounts from within the billing system in accordance with pre-established goals.
- Research and analyze accounts and payments, reverses balances to credit or debit if charges were improperly billed or if payments were incorrect.
- Contact in-house patients who are private pay, have previous unpaid balances, or will have large deductibles.
- Answer patient and insurance carrier inquiries regarding accounts.
- Receive and resolve patient complaints and/or misunderstandings about their account; gathers information for timely resolution of issues. Explains charges and procedures.
- Initiate recommendations and action plans for resolving accounts.
- Evaluate accounts to determine any write-offs or corrections required, including duplicate charges.
- Prepare refund request for any monies due to patient or insurance company.
- Respond to all phone calls from patients, insurance companies or other departments in an efficient and courteous manner.
- Handle all correspondence, documentation and files in a professional manner.
- Review various reports to identify denials and edits & determine action plans to eliminate these denials/edits in the future and determines appropriateness for appeal.
- Combine account balances as requested by patients.
- Investigate possibility of Medicaid linkage.
- Prepare correspondence to patient/guarantor as necessary.
- Complete documentation on all contact with patients or actions taken on accounts.
- Send billing statements and in-house collection letters.
- Process returned mail and update other accounts with correct addresses.
- Establish payment arrangements for scheduled procedures for self-pay balances prior to service.
- Research, identify and correct any special circumstances affecting delayed payment of accounts.
- Review delinquent accounts and use appropriate action according to policy, such as turning accounts over to pre-collect or collection. Document all action.
- Transmit file of accounts turned over to collection agency.
- Make appropriate changes in computer system when accounts roll from pre-collect to regular collection.
- Evaluate account for referral to governmental programs or SPH’s Community Care program.
- Update computer system and notifies collection agency when any pay directs are received on account.
- Interview patients and obtain financial statements, tax returns, etc. to qualify patients for community care or payment plans.
Other duties as assigned
- Coordinate activities, answers inquiries and provides documentation required by collection agencies and attorneys.
- Monitor performance of collection agencies.
- Authorize legal action when all other attempts to collect debt have been exhausted. Keep director current on legal aspects of collection concerns.
- File liens, probates and bankruptcies.
- Attend court proceedings as needed.
- Responsible for registering patients that present for outpatient labs or who have not pre-registered for their appointments.
- Provide cost estimates for procedures, when requested.
- Meet daily and monthly production standards.
- Elevate issues as appropriate to the supervisor.
- Keep up to date with statutes and legal regulations such as the Fair Debt Collection Act that could affect collection of receivables.
- Required: High School Diploma or equivalent
- Preferred: None
Licenses and Registrations
- Required: 1 to 3 years of customer service
- Preferred: A background in a health care environment or financial setting is highly desirable; General office experience with strong customer interaction will be considered.
- Required: None
- Preferred: None
- Required: None
- Preferred: None
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- Competitive health and dental insurance options
- Flexible paid time off to balance work and life
- Retirement plan with immediate vesting and employer match
- Free membership to our state-of-the-art fitness facility
- Generous tuition reimbursement
- Employer provided life and disability insurance