Patient Account Specialist

Patient Account Specialist

Job Category: Office & Clerical Requisition Number: PATIE009260

Full-Time Hybrid

Administration 6210 US-290 E Austin, TX 78723, USA

Description

About Austin Regional Clinic: Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas' largest professional medical groups with 35+ locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more.

Purpose: Assists incoming callers/patients with billing inquiries, by collecting all insurance and demographic information necessary to appropriately setup a patient account, while providing excellent customer service. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.

Essential Functions:

• Receives inbound telephone calls from internal and external customers. ie. Patients, Insurance Representatives.
• Asks appropriate verification questions prior to releasing confidential patient information in accordance to company policy/HIPAA guidelines.
• Reviews explanation of benefits documents with knowledge and ability to explain information to patients/customers.
• Provides financial counseling service/payment arrangements to walk-in patients with outstanding account balances.
• Maintains and follows up on work queue accounts in a timely manner and documents all actions with clear and accurate documentation.
• Receives patient refund request information and forwards to Refunds processing.
• Requests information on patient charges from Clinics and Coding Quality and follows up in a timely manner.
• Returns telephone calls to follow up with patients on status or outcome of their inquiry within the timeframes established by the department.
• Answers patient registration phone calls.
• Obtains all insurance and demographic information from patient necessary to setup accounts.
• Verifies insurance coverage and sets up new members for all insurance contracts.
• Updates insurance and demographic information on existing patients as provided by patient call or additional information received from site resources.
• Runs registration reports and follows up on incomplete or missing account information as indicated to complete registration process.
• Researches member account transactions for eligibility inconsistencies.
• Maintains complete, accessible, dated files and resource materials.
• Provides assistance to coworkers as requested and/or necessary.
• Documents productivity statistics reports to CBO Supervisor.
• Maintains thorough and effective communication with all coworkers.
• Utilizes Payor website systems and tools to accurately complete registration process.
• Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
• Regular and dependable attendance.
• Follows the core competencies set forth by the Company, which are available for review on CMSweb.
• Works holiday shift(s) as required by Company policy

Account Transactions/Insurance:

• Reviews account transactions for accuracy, and distributes patient credits.
• Uses appropriate transaction and ANSI codes per posting guidelines.
• Reviews and documents patient correspondence. Contacts patients to acknowledge receipts of correspondence in a timely manner, whenever necessary.
• Obtains updated insurance information, verifies and enters coverage and retro-adjudicates claims accordingly.
• Follows up with insurance carriers on payments and adjustments in order to resolve patient issue. Refers accounts to the Appeals department, if applicable.
• Reviews automated claim form and edits as necessary to reflect complete, accurate information.
• Utilize Payor websites efficiently and maintain confidential security passwords.

Collections:

• Receives credit card payments via telephone processes payments over the secured online portal.
• Establishes payment plans per Payment Agreement guidelines.
• Works closely with Collections department, collecting agencies, and/or directly with patients on payment of balances due.
• Sets up accounts with payment plan information in EPIC and the online bill pay tool, and clearly documents the terms of the agreement in EPIC.
• Consults with CBO Supervisor prior to offering discounts for non-covered services.
• Return telephone calls to follow up with patients on status of their inquiry within timeframes established by department.

Other Duties and Responsibilities:

• Performs other duties as assigned.

Qualifications Education and Experience: Required: High school diploma or GED. Experience with admitting/registration, insurance claims, or related customer service. Preferred: One (1) or more years of medical billing customer service experience.

Knowledge, Skills and Abilities:

• Must successfully complete the Patient Accounts Specialist II Skills Assessment Test.
• Ability to engage others, listen and adapt response to meet others' needs.
• Ability to align own actions with those of other team members committed to common goals.
• Excellent computer and keyboarding skills, including familiarity with Windows.
• Excellent verbal and written communication skills.
• Knowledge of and/or experience with CPT and ICD-9 coding.
• Knowledge of legislative and private sector third party regulations and guidelines.
• Ability to manage competing priorities.
• Ability to perform job duties in a professional manner at all times.
• Ability to understand, recall, and apply oral and/or written instructions or other information.
• Ability to organize thoughts and ideas into understandable terminology.
• Ability to apply common sense in performing job.

Certificate/License: None

Schedule: Monday-Friday 8am-5pm.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.