PATIENT ACCOUNTS SPECIALIST - PFS (FT) - Cody Regional Health

JOB TITLE: Patient Accounts Specialist

DEPARTMENT: Patient Financial Services

REPORTS TO: Revenue Cycle Director/ PFS Manager

JOB SUMMARY

The Patient Account Specialist consistently and timely reviews accounts to support quick and effective re-billing of accounts with denials and correct billing of patients. This position accurately and timely assists with posting of insurance, patient, and client payments to accounts. Assists patients and staff with any questions or concerns regarding accounts. Performs complex tasks requiring critical thinking skills. Reviews work queues, large dollar accounts, aged accounts and any special projects assigned by leadership.

JOB REQUIREMENTS

• High School diploma or equivalent and one year of claims processing/billing/collections experience; OR High School diploma or equivalent with three years of experience in a business office setting.
• Proficiency in Microsoft office suite products.
• Bachelor’s degree preferred.
• Knowledge of medical terminology, third party payer guidelines and reimbursement practices, and available financial resources for payment of balances due.
• Strong understanding of all patient accounting systems.

EXPERIENCE

• At least 1 year previous work experience in finance or financial services.
• Customer service experience.
• Previous hospital experience favorable.
• Payment posting experience preferred.
• Experience with health insurance is preferred.

SKILLS

• Strong computer and keyboarding skills required.
• Must be able to maintain confidentiality of all matters.
• Must have ability to communicate with staff and public in a friendly, courteous and helpful manner.
• Must have a high degree of organizational skills with the ability to multi-task.
• Must have strong Office Suite products knowledge including Word, Excel and Outlook, and the ability to use them proficiently.
• Customer Service skills.
• Detail oriented.
• Exceptional phone etiquette.

REQUIRED CERTIFICATIONS

HFMA Revenue Cycle certification preferred.

ESSENTIAL FUNCTIONS

• Review all payments posted the previous day including self-pay and insurance to ensure appropriate billing activity has occurred.
• Accurately corrects payment posting errors.
• Review patient accounts and apply or move payments, apply small balance adjustments, review credit balances, and make necessary corrections to ensure patients statements are processed accurately.
• Process account balance write-offs according to department policies. Identify and take action towards resolution of problematic accounts through potential refunds, adjustments, payments transfers, etc.
• Understand and appropriately handle denials, either by forwarding to follow up staff or facilitating write offs where appropriate.
• Process refunds to both patient accounts and insurance where appropriate.
• Assist Customer Service, and support the backlog of accounts that require self-pay review and correction of balances.
• Assist Cash Poster and Accounting with reconciliation of credit card deposits to bank account through payment module.
• Assist Financial Advocate in maintaining bankruptcy files and facilitating adjustments.
• Assign accounts deemed uncollectible to collection agencies after moving them to bad debt when appropriate. Monitor assignment of accounts for appropriateness and initiates change as required. Drop bad debt files to collection agencies on a bi-weekly basis
• Post payments for Self Pay Programs on the day they are brought to registration.
• Post payments received in mail to appropriate accounts.
• Run payment module reports on a weekly basis to reconcile payment plans set up with EMR.
• Compile and mail patient client statements monthly
• Complete review and take action of vendor reports and perform appropriate follow-up.
• Maintain department productivity guidelines and compliance with quality standards.

SECONDARY FUNCTIONS

• Provide backup support for Cash Poster position.
• Provide backup support for Financial Advocate position by counseling and evaluating the patient's financial situation, and complete the appropriate screening when necessary.
• May be required to perform other duties for which the individual is qualified.