POSITION SUMMARY: |
Evaluates patient accounts and takes appropriate action as necessary to assure timely payments or other disposition of patient accounts .
POSITION EXPECTATIONS AND RESPONSIBILITIES:
MINIMUM EDUCATION AND/OR EXPERIENCE:
- Expected to assist in the increase of cash collection and the decrease of Accounts Receivables aging for designated plan(s) using effective and efficient collection techniques, including, but not limited to, the use of individual plan(s) escalation and/or appeal processes, patient and/or physician office contact.
- Expected to be able to understand and effectively interpret payer contracts, Remittance Advices and Explanation of Benefits statements.
- Expected to demonstrate a working knowledge of the medical health insurance benefits provided by assigned payer and consistently and accurately explain these to patients.
- Expected to have knowledge of core hospital information systems relative to the Business Office, or the ability to learn the system.
- Expected to have the ability to function in Windows PC environment.
- Expected to have basic knowledge of Microsoft Office with infuses on the use of spreadsheets utilizing Excel.
- Expected to be able to use an adding machine.
- Expected to be able to read and comprehend simple instructions, short correspondence and memos.
- Expected to have basic mathematical skills.
- E xpected to assure timely follow up with the payers and/or patients to expedite payment of claims by effectively completing assigned work list as required by supervisor and/or manager.
- Expected to perform consistent, assertive, efficient and timely follow-up on accounts as determined by Management. This includes responding timely to Project Specialist or Management regarding high dollar accounts reviewed in Focus Meeting.
- Expected to take appropriate action to resolve accounts, including, but not limited to, adjustments, changing schedules, changing FC, and moving money to appropriate buckets.
- Expected to document relevant collection activity in account notes in a clear, succinct manner while meeting QR standards as outlined in the department policy. This includes complete documentation in QUIC requests.
- Expected to consistently use TRAC variances (STAT, QUIC) to ensure appropriate action was taken when applicable.
- Expected to review payment variances and remittances for resolution in an efficient and timely manner.
- Expected to utilize investigation and problem solving skills.
- Expected to recognize other duties may be assigned and that duties are subject to change.
- Expected to recognize the influence of beliefs and cultures on behaviors and accept strengths and limitations in others.
- Expected to exhibit adaptability, flexibility, self control and maturity in work and behavior
- Expected to exhibit calm responsiveness to emergency or stressful situations.
- Expected to recognize situations which require notification of a supervisor.
- Expected to correctly follow procedures and protocols, both written and oral.
- Expected to be able to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
- Expected to write simple correspondence.
- Expected to provide ancillary departments with accurate and courteous assistance in account follow-up matters, referring to management as necessary.
- Expected to communicate effectively orally and in writing.
- Expected to maintain a positive and professional working relationship with ancillary departments, physicians, physician office personnel, patients, payers, and external agencies, as observed by the supervisor and/or manager on a daily basis.
* Incumbent may be required to perform emergency duty before, during and/or beyond normal work hours or days in the event of an emergency, crisis situation or disaster (man-made or natural) including evacuation sites.
- High school diploma or general education degree (GED) OR Two years related experience and/or training (one year collections experience in healthcare collections preferred)
- Licensure/Regulation/Certification: N/A
*The person in this position will work in a smoke-free location, and is expected to adhere to all smoking restrictions.
*In the spirit of wellness for both our employees and patients, Boca Raton Regional Hospital has instituted a mandatory influenza prevention vaccination program. Current employees must receive the influenza prevention vaccination free of charge during the recognized flu season. As a condition of employment, new hires will be required to comply with all program rules. This is a mandatory program with the exception of documented medical or religious reasons for not receiving the vaccine. For further information on this progressive program, please contact Boca Raton Regional Hospital ’s Human Resources Department at 561-955-4075.
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Boca Raton Regional Hospital is an advanced, tertiary medical...