Receives and responds to telephone, written and walk-in inquiries from patients, attorneys, insurers and others, regarding patient accounts and billing issues. Assists patients with payment arrangements, accepts and posts payments, explain and resolves billing discrepancies. Initiates refunds where appropriate. Updates insurance and demographic information in the practice management system. Operates automated call distribution system during established call center hours.
Essential Duties and Responsibilities include the following. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.
1. Receives calls distributed by automated call center system during established call center hours.
2. Responds to inquiries efficiently, in order to maintain acceptable wait times for callers in queue.
3. Analyzes and explains account details, in response to inquiries.
4. Updates demographic and insurance information in the IDX practice management system.
5. Files claims, demands statements, and conducts account reviews, to ensure accurate account maintenance.
6. Recommends and posts account adjustments, within prescribed dollar limits, and initiates refunds as warranted.
7. Assists patients with establishment of reasonable budget plans to address self-pay balances.
8. Operates ground floor Customer Service office to assist walk-in clients.
9. Responds to written inquiries and correspondence.
10. Performs other duties as assigned or requested.
Performance Expectations and Accountability:
1. Ability to maintain current, appropriate, and competent knowledge with respect to patient accounting, basic coding, HIPAA privacy regulations and contractual relationships.
2. Ability to maintain a professional demeanor and demonstrate positive interpersonal skills at all times, in an often demanding and fast paced environment.
3. Achieve functional competence in the use of various computer applications, including IDX, Touchworks, Microsoft Word and Excel.
4. Maintain a high degree of accuracy, thoroughness, and attention to detail with all assigned tasks.
5. Ability to communicate effectively, both verbally and in writing.
6. Respond to requisite number of incoming calls in ACD system, and minimize duration of calls, in order to maintain optimal service level and efficiency.
7. Escalates critical issues appropriately.
The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Associates degree preferably in Business, Accounting, Finance, or Healthcare Administration.
A minimum of two years experience in a physician practice business office, or with a healthcare payer. An equivalent combination of education and experience is acceptable. Must be computer literate, with experience using Microsoft Office applications.