OUR CULTURAL BELIEFS
Patient Minded I act with the patient’s best interest in mind.
Client Delight I own every client experience and its impact on results.
Take Action I am empowered and empower others to act now.
Grow Talent I own my development and invest in the development of others.
Win Together I passionately connect with anyone, anywhere, anytime to achieve results.
Communication Matters I speak up to create transparent, thoughtful and timely dialogue.
Own It I hold myself and others accountable for results.
The Patient Collections Specialist is responsible for patient reimbursement services, with an emphasis on patient account management. They are responsible for the timely and accurate mailing of patient invoices for accounts with open balances that are over 90 days old. This position will also be responsible for collecting outstanding payments and answering questions in regards to patient’s accounts that are in collections. This position will work closely with the Patient Service Coordinators who are responsible for patient balances under 90 days and will assist with escalated issues for those accounts not in collections where required.
• Accurate and timely mailing of patient statements that are in collections
• In-depth reviews of open patient receivables to determine the cause of outstanding claims
• Partner with patients to develop and setup payment options to avoid aging of accounts
ESSENTIAL DUTIES AND RESPONSIBILITES:
• Proactive review of open accounts receivable to determine why claims aren’t being paid and work toward a timely solution with the payer to guarantee payments for our clients
• Work denials or claim appeals to avoid claims aging over 90 days
• Proactive review of assigned accounts to ensure they are processed correctly
• Manage outstanding payer receivables and collect open balances
• Keep account aging balances below 90 days to ensure we are meeting client expectations
• Work with contacts at the health plans to resolve short payments on accounts in a timely manner
• Review and resolve overpayments and recoupments to ensure account balances are accurate
• Review accounts and make appropriate claim level adjustments as needed
• Follow up on accounts by phone/email/payer site to ensure received an in process and be able to report the status of all claims
• Track issues, prioritize efforts and escalate complicated payer cases including claims appeals and review with leadership during monthly A/R meetings
• Partner with the finance team to review balances and pull required information for client audits as needed
• Support and partner with the, Patient Service Coordinators and Payer Contracting Specialists to ensure patient and client satisfaction
• Limited travel may be required
The above list reflects the general details necessary to describe the principle and essential functions of the position and shall not be construed as the only duties that may be assigned for the position.
An individual in this position must be able to successfully perform the essential duties and responsibilities listed above. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.
The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.
• Associate’s Degree, emphasis in health care management, marketing, finance or related field or in lieu of educational requirement 2 + years of relevant work experience
• 2 years healthcare billing and collections experience in addition to educational requirement
• Basic understanding of revenue cycle processes
• Excellent written, verbal, organizational and judgment skills
• Ability to work independently with minimal supervision
• Strong strategic, negotiation and organization skills
• Proficiency in Microsoft Office suite of applications, including Word, Excel, Outlook, and PowerPoint
• Bachelor’s Degree in related Field
• Intermediate level understanding of revenue cycle processes
PHYSICAL AND MENTAL DEMANDS:
This is a largely sedentary role. While performing the duties of this job, the employee is regularly required to talk, hear, type and engage in repetitive motion.
The employee frequently is required to walk; use hands to finger, handle or feel; and reach with hands and arms. The employee is occasionally required to stand or grasp. The employee is intermittently required to stoop or crouch; push or pull; or kneel.
The employee must occasionally lift and/or move up to 10 pounds and intermittently lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
This role requires mental alertness. The employee must regularly communicate both verbally and written; concentrate on tasks; and remember and observe details. The employee must frequently adjust to changes; handle stress and emotions; and think analytically.
The mental and physical requirements described here are representative of those that must be met by an individual to successfully perform the essential functions of this position.
This job operates in a professional office environment. This role routinely uses standard office equipment. The noise level in the work environment is usually moderate. The employee is not substantially exposed to environmental conditions.
The work environment characteristics described here are representative of those an individual encounters while performing the essential functions of this position.