Senior A/R Specialist

Position Summary

As the Senior Accounts Receivable Specialist, you are responsible for motivating the Patient Accounts team daily to provide guidance, help troubleshoot, resolve issues, and educate on the process. Assists Supervisor and Manager with the daily activities of the department to ensure department standards are regularly met, including policies and procedures being followed, as well as assuring staff are well versed in payer contracts. Acts as subject-matter expert with EMR systems, department procedures, workflows and continually educates Patient Accounts staff on all aspects of their role, such as follow-up, special projects, and accounts receivable.
Essential Functions and Responsibilities Include the Following:

1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors.
2. Completes review of third-party outstanding balances and takes appropriate steps to resolve and reconcile outstanding balances striving to meet best practice performance.
3. Reviews correspondence for appropriate action to resolve accounts.
4. Researchs and initiates refunds to patients or insurance carriers as needed.
5. Sends inquiries to patients regarding inaccurate or incomplete information.
6. Completes charge adjustments and allowances entries on accounts as needed.
7. Recodes accounts by insurance carrier and plan number and enters into the hospital EMR for re-billing purposes.
8. Processes rejections on third party accounts.
9. Reviews on-line billing edits for errors, corrections, or missing information.
10. Assures adherence to federal and state billing regulations.
11. Monitors host system and biller scrubber to ensure timely resolution of unbilled accounts.
12. Completes rebilling process for late charges daily.
13. Reviews third party remittance advice to ensure proper payment is received from insurance carrier based on contract arrangement.
14. Works with vendors as necessary to reconcile and resolve outstanding accounts.
15. Assures payers pay claims timely and according to contact provisions.
16. Responsible for aging review and high-risk accounts review
17. Responsible for training of staff and assisting with staff performance audits following the WPH Revenue Cycle Performance Expectations.
18. Responsible for quality reviews for the staff to lead team to meet goals and performance metrics.
19. Responsible for reporting to management regarding billing and claim delays.
20. Responsible for escalating management issues as identified.
21. Responsible to set department and or unit meetings weekly, bi-weekly and or monthly.
22. Works in conjunction with management to identify issues and trends and communicate information effectively.
23. Reports on outcomes of determined processes and workflows and contributes to the development and standardizing workflows and procedures.
24. Assists management and is a positive change agent in all departmental employee engagement initiatives.
25. Works with staff to improve both intradepartmental and employee satisfaction maintained.
26. Responds to concerns and/or complaints from patients, the public, medical staff, subordinates, and/or other hospital employees pertaining to assigned areas in order to maintain positive customer relations; researches and investigates issues; prepares written or oral responses as needed.
27. Assists leadership with the oversight of the preparation and maintenance of documents and information in order to comply with administrative policies as well as JCAHO and other regulations.
28. Performs all other related duties as assigned.
29. Education & Experience Requirements

Minimum Education:

• High School Diploma or GED required.
• Graduate of an accredited college or university with a B.S. in Business/Healthcare Administration strongly preferred or equivalent combination of education and related work experience.

Minimum Experience:

• Minimum of (3) to (5) years of hospital patient accounting / business office experience required.
• Previous Team Lead experience in a hospital setting is strongly preferred.
• Familiarity with electronic medical record systems, EPIC preferred.
• Proficiency with Microsoft office/Excel to include reporting and executive level is required.
• Strong leadership skillset with the ability to educate and motivate team members on Patient Account functions.
• Strong communication skills required
• Knowledge of medical terminology required.
• Must be detail-oriented, able to problem-solve, multitask and perform various patient accounting duties on demand.
• Effective 12/1/2022, the HBI (Healthcare Business Insights) one-time certification course is required and must be completed during the onboarding period and prior to the start date (Certified Patient Financial Services Specialist - CPFSS).

Core Competencies

• Must be able to remain in stationary position at least 50% of the time.

• The person in this position will need to communicate effectively.
• Ability to multi-task to meet the needs of the department.
• Integrity to handle the confidential aspects of work.
• Maintains composure under stress.
• Must be able to speak, write, understand, and communicate in the English language.

Physical/Mental Demands/Requirements & Work Environment

• May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicalsemployee may be exposed to are listed in the hospital's SDS (Safety Data Sheet) data base and may be accessed through the hospital's Intranet site (Employee Tools/SDS Access). A copy of the SDS data base can also be found at the hospital switchboard, saved on a disc.
• The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc.
• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine and computer printer.
• Must be able to remain in stationary position at least 50% of the time.
• Must be able to attend meetings in other locations across the campus.
• Must be comfortable with public speaking.

Primary Population Served

Check appropriate box(s) below:

• Neonatal (birth - 28 days)

• Patients with exceptional communication needs

• Infant (29 days - less than 1 year)

• Patients with developmental delays

• Pediatric (1 - 12 years)

• Patients at end of life

• Adolescent (13 - 17 years)

• Patients under isolation precautions

• Adult (18 - 64 years)

• Patients with cultural needs

• Geriatric (> 65 years)

•All populations

• Bariatric Patients with weight related comorbidities

•Non-patient care population

The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of White Plains Hospital

Annual Salary: $61,972.95 to $92,959.23