Senior Patient Account Specialist

Job Description

Job Description

Summary:

• Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. Responsibilities include performing collection activities related to follow-up and account resolution, communicating with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction are essential. Associates are expected to understand the overall collection work processes for both active Accounts Receivable (A/R) and Bad Debt (BD) inventory.

Responsibilities:Core Responsibilities

• Meets expectations of the applicable OneCHRISTUS Competencies:
  • Leader of Self
  • Leader of Others
  • Leader of Leaders
• Provides effective collection services to ensure successful account recovery in accordance with client requirements, state regulations, and TLRA business objectives.
• Documents and updates patient account information accurately and timely in TLRA's collection software.
• Handles inbound patient and/or insurance carrier calls professionally, resolving account inquiries and issues.
• Utilizes collection tools effectively to meet or exceed productivity and quality goals.
• Researches and analyzes account issues and resolves them accurately and promptly.
• Meets daily productivity standards.
• Promotes positive patient relations through respectful and compassionate communication.
• Demonstrates proficiency with Microsoft Word and Excel.
• Maintains general knowledge of hospital Accounts Receivable (A/R).
• Completes additional projects and assignments as required.

Insurance Collections

• Maintains current knowledge of payer collection requirements.
• Collects outstanding balances from third-party payers while complying with state and federal collection laws.
• Ensures collection efforts are ethical, thorough, and properly documented.
• Coordinates with internal departments to obtain information needed for appeals, pending claims, and claim processing issues.

Self-Pay Collections

• Handles self-pay accounts with a strong customer service focus while maximizing collections.
• Assists patients in identifying available financial assistance programs.
• Establishes appropriate payment arrangements when financial assistance is unavailable.
• Participates actively in team meetings and communicates ideas, concerns, and solutions effectively.
• Demonstrates strong teamwork and communication skills.

Physician Billing & Collections

• Ensures proper reimbursement for services rendered.
• Files appeals accurately and within required timelines.
• Reviews accounts and determines appropriate follow-up using Six Sigma practices.
• Identifies underpayments and overpayments and resolves reimbursement discrepancies.
• Validates commercial insurance claims according to contract terms.
• Utilizes Meditech and CollectLogix software.
• Monitors billing errors, communicates issues to appropriate teams, and identifies trends for process improvement.

Job Requirements:Education

• High School Diploma or equivalent required.

Experience

• 3–5 years of relevant experience preferred.
• Experience in:
  • Healthcare billing and collections
  • Medical collections
  • Customer service call center environment
  • Collection agency environment
• College education, insurance claims experience, or healthcare billing trade school education may substitute for formal hospital experience.

Technical Skills:

• Microsoft Word
• Microsoft Excel
• Meditech
• CollectLogix
• Hospital Accounts Receivable (A/R)
• Insurance Claims Processing
• Medical Collections